Mortality characteristics in sumadija district from 2010 – 2017

Mortality rate represents a number of deaths on a particular territory per time unit. There are general and specific mortalities. The aims at analysing the characteristics of mortality in Sumadija District for the time period ranging from 2010 – 2017. The study includes all death cases in the District of Sumadija in period 2010-2017, 34681 cases. The data are described and analysed with χ² test and linear trend. The trend analysis does not indicate any significant vari-ations during the given time span. The gender analysis re-veals that there is a significantly higher number of deceased persons among male population (52.2%, 47.8%, р<0.05). The average age of the deceased females (76.2±13.4) was higher than the average age of males (73.8±14.1) (р<0.05). The cause-specific analysis shows that natural causes of death dominate absolutely (96.5%) over violent deaths (2.7%) and undetermined causes (0.8%). The distribution of death causes according to ICD 10 shows that the most frequent causes of death are heart and blood vessel diseases, respiratory and neoplasm diseases. The life expectancy of the inhabitants of Sumadija District is increasing over time. There was a slight decrease in the mortality rates during the observed time period. The highest number of the deceased people is 65 or more years old. Men have higher mortality rates throughout their lives. Natural death and non-communicable diseases are dominant. The most common causes of death are heart and blood vessels diseases, in women, and respiratory and neo-plasm diseases, in men

Normotensive rats with PCOS exhibit the hypertensive pattern: focus on oxidative stress

Numerous evidence implies complex interrelations between polycystic ovary syndrome (PCOS) and hypertension (HT) in reproductive-age women. In this study, we aimed to investigate the potential strain differences in ovarian morphology, hemodynamic, and biochemical characteristics in an androgen-induced PCOS rat model. A total of 24 rats of 3 weeks old (12 Wistar Kyoto - WK and 12 spontaneously hypertensive rats - SHR) were divided into four groups: WK, WK PCOS, SHR, and SHR PCOS. PCOS was induced by daily s.c. injections of testosterone enanthate (1 mg/100 g body weight) administered for 5 weeks. PCOS induction led to estrus cyclicity cessation, cystic ovarian appearance, and sex hormones disturbances in both strains. The morphometric parameters in ovaries were altered in a manner of PCOS-related changes in both strains (higher number in preantral, atretic, and cystic follicles). Ultrasonographically, a significant decrease in ovarian volume (OV) was registered in PCOS groups but also in SHR compared to WK rats. All blood pressure parameters were higher in SHR compared to WK. PCOS modeling increased systolic, mean arterial, and pulse pressure in WK strain, while in SHR, only mean arterial and pulse pressure were higher. Alterations in oxidative stress parameters could provide a molecular basis for PCOS-related changes: in PCOS groups, thiobarbituric acid reactive substance and superoxide anion radical levels were higher in both strains, while superoxide dismutase and glutathione were significantly lowered

Enhancing predictive accuracy of the cardiac risk score in open abdominal aortic surgery: the role of left ventricular wall motion abnormalities

BackgroundOpen abdominal aortic surgery carries many potential complications, with cardiac adverse events being the most significant concern. The Vascular Study Group Cardiac Risk Index (VSG-CRI) is a commonly used tool for predicting severe cardiac complications and guiding clinical decision-making. However, despite the potential prognostic significance of left ventricular wall motion abnormalities (LVWMAs) and reduced LV ejection fraction (LVEF) for adverse outcomes, the VSG-CRI model has not accounted for them. Hence, the main objective of this study was to analyze the added value of LV wall motion on the discriminatory power of the modified VSG-CRI in predicting major postoperative cardiac complications.MethodsA prospective study was conducted involving 271 patients who underwent elective abdominal aortic surgery between 2019 and 2021. VSG-CRI scores were calculated, and preoperative transthoracic echocardiography was conducted for all patients. Subsequently, a modified version of the VSG-CRI, accounting for reduced LVEF and LVWMAs, was developed and incorporated into the dataset. The postoperative incidence of the composite endpoint of major adverse cardiac events (MACEs), including myocardial infarction, clinically relevant arrhythmias treated with medicaments or by cardioversion, or congestive heart failure, was assessed at discharge from the index hospitalization, with adjudicators blinded to events. The predictive accuracy of both the original and modified VSG-CRI was assessed using C-Statistics.ResultsIn total, 61 patients (22.5%) experienced MACEs. Among these patients, a significantly higher proportion had preoperative LVWMAs compared to those without (62.3% vs. 32.9%, p &lt; 0.001). Multivariable regression analysis revealed the VSG-CRI [odds ratio (OR) 1.46, 95% confidence interval (CI) 1.21–1.77; p &lt; 0.001] and LVWMA (OR 2.76; 95% CI 1.46–5.23; p = 0.002) as independent predictors of MACEs. Additionally, the modified VSG-CRI model demonstrated superior predictability compared to the baseline VSG-CRI model, suggesting an improved predictive performance for anticipating MACEs following abdominal aortic surgery [area under the curve (AUC) 0.74; 95% CI 0.68–0.81 vs. AUC 0.70; 95% CI 0.63–0.77; respectively].ConclusionThe findings of this study suggest that incorporating preoperative echocardiography can enhance the predictive accuracy of the VSG-CRI for predicting MACEs after open abdominal aortic surgery. Before its implementation in clinical settings, external validation is necessary to confirm the generalizability of this newly developed predictive model across different populations

Facial profile esthetics change of class II malocclusion patients treated with the Herbst appliance as perceived by orthodontists and laypersons

Introduction/objective: The recognition of differences in individual assessment of facial attractiveness could be valuable assistance in planning the orthodontic treatment. The aim of this study was to compare facial profile attractiveness changes of patients treated with the Herbst appliance perceived by orthodontists and laypersons. Methods: The patient sample comprised 33 young Caucasian still-growing patients, aged 14–18 years, with skeletal class II malocclusion treated with the Herbst and multibracket appliances. Facial profile photographs before and after the treatment were shown to 54 orthodontists and 50 laypersons. In the esthetics oriented poll, the evaluators rated the change in facial appearance. Results: The attractiveness scores differed between the two rater groups (p lt 0.001), with orthodontists being more generous, whereas there was no significant difference between female and male evaluators in both groups (p > 0.05). However, scores differed significantly in grading female and male patients (p lt 0.001), so that female patients got higher scores; younger evaluators graded more critically between different age groups of the evaluators (p lt 0.001), as well as between the patients with different initial severity of malocclusion (p lt 0.001). Conclusion: The difference in attractiveness scores differed between two groups, with laypersons being more critical than orthodontists. Higher scores were given to female patients by both groups, as well as by the evaluators in the older age group.Uvod/Cilj: Prepoznavanje razlika u individualnoj proce- ni facijalne atraktivnosti može biti od velike pomoći u planiranju ortodontske terapije. Cilj rada je bio da se uporedi promena atraktivnosti profila lica bolesnika tretiranih Herbstovim aparatom od strane ortodonata i laika. Metode: Uzorak se sastojao se od 33 ispitanika uzrasta 14–18 godina, koji su imali malokluziju II klase i lečeni Herbstovim aparatom u kombinaciji sa gornjim i donjim fiksnim aparatom. Njihove profilne fotografije pre i posle terapije pregledali su 54 ortodonta i 50 laika. Oni su ocenjivali, u vidu ankete, promenu facijalne atraktivnosti. Rezultati: Ocene facijalne privlačnosti razlikovale su se između dve grupe (p lt 0,001), tako što su ortodonti dava- li veće ocene, dok nije bilo statistički značajne razlike između polova u obe grupe (p > 0,05). Međutim, rezultati su se značajno razlikovali pri ocenjivanju muških i ženskih bolesnika (p lt 0,001), te su bolesnice dobile veće ocene. Takođe, rezultati su se značajno razlikovali između različitih starosnih grupa ocenjivača (p lt 0,001), tako da je mlađa grupa davala niže ocene, te bila kritičnija u pro- ceni. Razlika je bila značajna i kod ocenjivanja bolesnika sa različitim stepenom izraženosti anomalije (p lt 0,001). Zaključak: Razlika u ocenama facijalne privlačnosti postojala je između dve grupe, te su laici bili kritičniji u ocenjivanju u odnosu na ortodonte. Veće ocene dobile su bolesnice od strane obe grupe, a starija uzrasna grupa ocenjivala je većim ocenama sve bolesnike

Attitudes and knowledge of nurses on organ legacy and transplantation

Introduction Nurses represent an important link in mediating between the potential donors and their relatives'consent to organ and tissue transplantation.The message of the Health Department to potential donors about the importance of organ donation was supported by the Serbian Orthodox Church, the army and other institutions through media campaigns. Nurses could contribute to this action by their personal example. Objective The aim of this study was identification and bivariate analysis of nurse attitude about organ donation, their knowledge about the importance of transplantation as treatment methods, as well as the connection between work experience and education level with the formation of attitudes and new skills. Methods In this cross-sectional study, 291 nurses from the Clinical Center of Serbia, Belgrade, filled in the questionnaire on the effect of correlation between the length of the service and level of education on knowledge and attitudes toward organ transplantation and organ donation. Results Out of 291 respondents, 67.4% have completed the nursing school and 32.6% have higher education. The majority (63.9%) of respondents knew that the EEG was the most valid method for determining brain death. The question regarding the possibility of buying organs was answered correctly by 68.7% of respondents. A large majority (91%) would accept organ transplant, if needed, but only 32.0% would be organ donors, and only 0.3% owned a donor card. In contrast, one third of nurses were already blood donors. Conclusion In case of necessary transplantation, nurses would accept someone else's organ, though they do not possess donor cards, but just few would donate their organs. It is possible that prejudice arises from ignorance and distrust in the health policy of the Republic of Serbia. However, besides negative attitude, nurses have expressed interest in learning and professional development in the area of transplantation

The value of the post mortem analysis of carboxyhemoglobin concentration in the blood: A 15-year study

Introduction/Objective The purpose of this retrospective study was to assess carboxyhemoglobin (HbCO) concentration in all autopsy cases of fire and non-fire victims - all those who have been suspected to be under the influence of carbon monoxide (CO) in the Belgrade area during a 15-year period (1990-2005). Methods Correlations between the concentration of HbCO, circumstances of death, vital signs, and prior health conditions, smoking and history of alcohol-abuse, have been particularly analyzed in 192 autopsy cases. Results The investigation included 52 (27%) females and 140 (73%) males, their average age being 50.78 years. CO poisoning has been established as the cause of death in 74 cases (38%). The manner of death in 170 cases (89%) was an accident, in eight (3%) suicide, in two (1%) murder, in 11 (6%) natural death, and in one case the manner of death hasn't been established. Such distribution of the manner of death differentiates this study from others of similar type, and it is conditioned by the specificity of life in this region. Conclusion The predictors of a high HbCO concentration are the sex, cause of death, manner of death, soot aspiration, lower-degree burns. According to the results, we profiled a typical victim of CO poisoning.Uvod/Cilj Cilj retrospektivne studije bio je određivanje koncentracije karboksihemoglobina (HbCO) u svim slučajevima žrtava iz požara i onih koji nisu u vezi sa njim, na području Beograda, u periodu 1990-2005, odnosno svih sluačajeva za koje se sumnjalo da su bili izloženi ugljen-monoksidu (SO). Metode U 192 slučaja obdukcije posebno su analizirane: korelacija između koncentracije HbCO, okolnosti umiranja, vitalnih reakcija, prethodnog zdravstvenog stanja, pušenja i zloupotrebe alkohola. Rezultati Ispitivanje je obuhvatilo 52 (27%) žene i 140 (73%) muškaraca prosečne starosti 50,78 godina. Trovanje SO je utvrđeno kao uzrok smrti u 74 slučaja (38%). U 170 slučajeva (89%) radilo se o zadesima, u 8 (3%) o samoubistvima, u 2 (1%) o ubistvima. U 11 slučajeva (6%) reč je bilo o prirodnoj smrti, dok u jednom slučaju uzrok smrti nije ustanovljen. Ovakva raspodela diferencira ovu studiju od sličnih i uslovljena je specifičnostima života u regionu. Zaključak Prediktori visoke koncentracije HbCO su pol, uzrok smrti, način smrti, aspiracija čađi, stepen izgorevanja. Na osnovu rezultata napravljen je profil žrtve trovanja SO

Distribution of vaccine-related high-risk human papillomaviruses and their impact on the development of cervical dysplasia in women in Montenegro

Cervical cancer (CC) is the third leading cause of death in women in Montenegro. Human papillomavirus (HPV) is the causative agent of CC however, HPV genotype distribution varies across regions. This study examined the distribution and impact of vaccine-related high-risk (HR)-HPVs on the development of cervical dysplasia in Montenegrin women. A total of 187 women who had a clinical indication for cervical biopsy were enrolled. Based on histopathological findings, women were classified into 2 groups, with and without dysplasia. HR-HPV was detected by real-time PCR. Twelve HR-HPV genotypes were detected in 40.6% of cervical samples. The 7 most prevalent HR-HPVs in order of decreasing frequency were HPV 16 (39.5%), 45 (23.7%), 31 (21.0%), 33 (17.1%), 18 (6.6%), 52 (6.6%), and 58 (6.6%), all of them are targeted by nonavalent vaccine. Vaccine-related HR-HPVs had a higher prevalence (92.1%) than the other HR-HPVs detected in HR-HPV-positive samples. Among HR-HPV-positive women, HPV 16 and 33 were more common in women with dysplasia than in those without dysplasia (HPV 16: 28.9 vs 7.2%; HPV 33: 11.8 vs 3.6%). HPV 16 was the most common HR-HPV genotype in cervical samples, followed by HPV 45, 31, 33, 18, 52, and 58. HPV 16 and 33 were shown to be associated with the development of cervical dysplasia. These results indicate that prophylactic nonavalent vaccine can potentially prevent approximately 90% of HR-HPV infections and 60% of cervical dysplasia cases in Montenegrin women

Retention force of overdenture retained with telescopic crowns: A comparison of polyether ether ketone and zirconia ceramic telescopic crowns

Introduction/Objective. Recently, new materials for double crowns have been introduced, such as zirconia and polyether ether ketone (PEEK). However, some characteristics of these materials, such as retentive force and duration of “settling in phase,” have not been investigated sufficiently. During the “settling in phase,” telescopic overdenture has not yet achieved its definitive retention force, and it can be harmful for periodontal tissue if the value is above optimal for a long period of time. The objective was to measure the in vitro overall pull-off force of telescopic crowns where primary crowns were made from zirconia ceramics and a survey of the “settling in phase” duration. Methods. Forty zirconia primary telescopic crowns were produced on prepared canine teeth. Twenty secondary crowns were of PEEK and other 20 of zirconia with electroplated gold copings. The pull-off force measurements were conducted utilizing a dynamometer until a constant value was obtained. Results. The specimens of the PEEK group showed higher initial retentive force values. Settling in phase was finished between 800 and 900 cycles of separation for both groups. Comparing the value of the pull-off force between individual different cycles, a statistically significant reduction was recorded up to the 800th cycle, while between the 800th and the 900th cycle there was no difference. Conclusions. The settling in phase was finished between 800 and 900 cycles of separation in both groups. Final retentive force values for both tested telescopic groups were in the optimal range which is 5–9 N per one telescopic crown.Uvod/Cilj Poslednjih godina uvedeni su u praksu novi materijali za dvostruke krune, kao što su cirkonija i polietereterketon (PEEK). Međutim, neke karakteristike ovih materijala nisu dovoljno ispitane, kao što su retenciona sila i trajanje "faze uhodavanja". "Faza uhodavanja" je inicijalni period upotrebe teleskopske proteze kada finalna retenciona sila još uvek nije postignuta, i može imati štetni uticaj na parodontalno tkivo ako su u tom periodu sile previsoke i predugo traju. Cilj je bio da se izmeri in vitro ukupna sila razdvajanja teleskopskih kruna, gde su primarne krune izrađene od cirkonijumske keramike, i ispitati trajanje faze uhodavanja. Metode Četrdeset primarnih teleskopskih kruna od cirkonijumske keramike je izrađeno na preparisanim očnjacima. Dvadeset sekundarnih kruna je izrađeno od PEEK-a, i još 20 kruna od cirkonije sa galvanizovanim zlatom. Za merenje sile razdvajanja korišćen je dinamometar. Spajanje i razdvajanje teleskopskih kruna i merenje sile razdvajanja je vršeno dok nije dobijena konstantna vrednost. Rezultati Uzorci iz grupe PEEK pokazali su višu inicijalnu vrednost retencione sile. Faza uhodavanja je završena između 800 i 900 ciklusa razdvajanja kod obe grupe. Kada se uporede individualne vrednosti sile razdvajanja između različitih ciklusa, statistički značajno smanjenje je zabeleženo do 800. ciklusa, dok između 800. i 900. ciklusa nije bilo razlike. Zaključak Faza uhodavanja je završena između 800 i 900 ciklusa razdvajanja u obe grupe. Finalna retenciona sila kod obe testirane grupe pokazala je optimalne vrednosti, koje iznose 5-9 N po teleskopskoj kruni

Perioperative myocardial ischemia in coronary artery disease patients undergoing abdominal nonvascular surgery

BACKGROUND: The incidence of perioperative myocardial ischemia (PMI) is the highest in patients who have coronary artery disease, and it is the best predictor of intrahospital morbidity and mortality. OBJECTIVE: To identify predictors of PMI in patients who have coronary artery disease and are undergoing abdominal nonvascular surgery. METHODS: A prospective, observational, clinical study of 111 consecutive patients with angiographically verified coronary artery disease, scheduled for open abdominal nonvascular surgery, was conducted. Patients received general anesthesia and were monitored by continuous electrocardiogram during surgery and immediately postsurgery (72 h period) in the intensive care unit at the University Clinical Center (Belgrade, Serbia). All of the patients had 12-lead electrocardiography immediately after the surgery, on postoperative days 1, 2 and 7, and one day before discharge from hospital. The patients were monitored until the 30th postoperative day. RESULTS: A total of 24 predictors for PMI were analyzed. The Pearson's chi(2) test and a binomial logistic regression model were used for statistical analysis. A significant difference in the incidence of PMI was found in the coronary artery disease patients with an associated risk factor (14 of 24 risk factors) compared with those without the risk factor. In particular, a highly significant difference in the incidence of PMI was found in coronary artery disease patients with angina pectoris, compared with those without angina pectoris. CONCLUSION: Using the multivariate logistic regression analysis, angina pectoris was an independent predictor of PMI