Analysis of risk factors for occlusions of a synthetic femoropopliteal bypass graft

© 2015, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. Femoropopliteal bypass is a revasculariza-tion technique of lower extremities with excellent outcome. The great saphenous vein is the best graft material, but if it is not adequate or has been removed, synthetic grafts are an useful al-ternative. Graft occlusion is the most significant complication with the most serious consequences. The aim of this study was to analyse predictive factors for the synthetic femoropopliteal bypass occlusions. Methods. This retrospective case-control study included all patients who underwent synthetic femoropop-liteal bypass due to peripheral arterial occlusive disease at the Vascular Surgery Center, Clinical Center of Kragujevac, Serbia, from 2007 to 2013. The cases group were the patients with femoropopliteal graft occlusion (n = 44), with the control group consisted of the patients without such an outcome (n = 88). Re-sults. Significant effects to occlusion were: concomitant cardio-vascular disease (adjustedOR 27.05; 95% CI 4.74; 154.35), a type of femoropopliteal bypass (adjustedOR 16.50; 95% CI 4.05; 67.24), previous vascular intervention (adjustedOR 4.67; 95% CI 1.20; 18.14), clinical stage of the disease (adjustedOR 3.73; 95% CI 1.94; 7.18), administration of postoperative oral anticoagulant therapy (adjustedOR 0.05; 95% CI 0.01; 0.23) and the use of angiotensin converting enzyme inhibitors (adjustedOR 0.14; 95% CI 0.03; 0.70). A significant synergism was shown for the following combina-tions of the observed risk factors: type of femoropopliteal bypass and cardiovascular disease, type of femoropopliteal bypass and previous vascular intervention, previous vascular intervention and cardiovascular disease, previous vascular intervention and beta blockers, cardiovascular disease and diabetes, type of femoropopliteal bypass and antiaggregant therapy, clinical stage of disease and cardiovascular disease, previous vascular interven-tion and antiaggregant therapy. Conclusion. Concomitant car-diovascular disease, below-knee femoropopliteal bypass, ad-vanced stage of vascular disease and non-use of anticoagulant therapy and angiotensin-converting enzyme inhibitors are the significant predictors of graft occlusion after synthetic femoro-popliteal bypass. Their synergistic effect determines the impor-tance of diabetes, use of beta blockers and platelet antiaggregant therapy

Socio-demographic inequalities in satisfaction with primary health care and utilization of chosen doctors’ services: a cross-sectional study

Aim: The aim of the study was to examine socio-demographic inequalities in user satisfaction with PHC and utilization of chosen doctors’ services. Methods: This cross-sectional study was conducted in 2016 among 232 respondents who participated in PHC user satisfaction survey in PHC center Valjevo, Serbia. Inclusion criteria were an age of at least 20 years, sufficient skills of Serbian language to fill in questionnaires and consent to participation. Two hundreds and six patients completed an anonymous questionnaire about the user satisfaction with PHC. Results: The chosen doctor was seven times more often visited by the elderly (OR=7.03) and almost three times more often by the middle-aged (OR=2.66) compared to the youngest category of respondents. Those with low education and poor financial status of the household visited a doctor four (OR=4.14) and almost nine times (OR=8.66) more often, respectively, compared to those with high education and good socioeconomic status. A statistically significant higher level of PHC satisfaction was recorded in the rural population (p<0.001) and among respondents with poor socioeconomic status of the household (p=0.014). Conclusion: The chosen doctor was more frequently visited by respondents with low education and those with poor socioeconomic status of the household, while a higher degree of satisfaction with PHC was recorded in the rural population as well as in those with poor socioeconomic status of the household. &nbsp

Socio-demographic inequalities in satisfaction with primary health care and utilization of chosen doctors’ services: a cross-sectional study

Aim: The aim of the study was to examine socio-demographic inequalities in user satisfaction with PHC and utilization of chosen doctors’ services. Methods: This cross-sectional study was conducted in 2016 among 232 respondents who participated in PHC user satisfaction survey in PHC center Valjevo, Serbia. Inclusion criteria were an age of at least 20 years, sufficient skills of Serbian language to fill in questionnaires and consent to participation. Two hundreds and six patients completed an anonymous questionnaire about the user satisfaction with PHC. Results: The chosen doctor was seven times more often visited by the elderly (OR=7.03) and almost three times more often by the middle-aged (OR=2.66) compared to the youngest category of respondents. Those with low education and poor financial status of the household visited a doctor four (OR=4.14) and almost nine times (OR=8.66) more often, respectively, compared to those with high education and good socioeconomic status. A statistically significant higher level of PHC satisfaction was recorded in the rural population (p<0.001) and among respondents with poor socioeconomic status of the household (p=0.014). Conclusion: The chosen doctor was more frequently visited by respondents with low education and those with poor socioeconomic status of the household, while a higher degree of satisfaction with PHC was recorded in the rural population as well as in those with poor socioeconomic status of the household.   Conflicts of interest: None declared. &nbsp

Intersections of Our World

There are several situations where the type of a street intersections can become very important, especially in the case of navigation studies. The types of intersections affect the route complexity and this has to be accounted for, e.g., already during the experimental design phase of a navigation study. In this work we introduce a formal definition for intersection types and present a framework that allows for extracting information about the intersections of our planet. We present a case study that demonstrates the importance and necessity of being able to extract this information

Local guidelines for drug treatment of patients with covid-19

© 2020, Serbian Medical Society. All rights reserved. Objective. Until now, there have been no guidelines for the use of drugs in patients with COVID 19 in the Republic of Serbia that have been authorized and published in the professional or scientific literature, or on the official websites of the Ministry of Health or healthcare institutions. The aim of this paper is to present a local guideline for the use of drugs in patients with COVID 19 and the process of its development and adoption. Methods. The guideline proposal was prepared by a working group based on the results of a systematic research of the medical literature, and quality control of found publications from the category “clinical practice guidelines”. The proposal of the working group was considered and adopted at the sessions of the Drug / Therapeutics Committee and the Quality Assurance Committee of the University Clinical Centre Kragujevac. Results. The guideline's recommendations are based on the type of patient, and all have the same degree of recommendation and the same quality of evidence on which they are based. Patient types are formed according to the severity of the disease and the need for respiratory support, as well as according to the risk of secondary bacterial infection. Conclusion. The local guideline to the use of drugs in patients with COVID 19 was developed and adopted in a short period of time, primarily due to the need for its urgent use. A revision of this guide is planned after 6 months from the moment of adoption

Heterosis in age-specific selected populations of a seed beetle: Sex differences in longevity and reproductive behavior

We tested mutation accumulation hypothesis for the evolution of senescence using short-lived and long-lived populations of the seed-feeding beetle, Acanthoscelides obtectus (Say), obtained by selection on early-and late-life for many generations. The expected consequence of the mutation accumulation hypothesis is that in short-lived populations, where the force of natural selection is the strongest early in life, the late-life fitness traits should decline due to genetic drift which increases the frequency of mutations with deleterious effects in later adult stages. Since it is unlikely that identical deleterious mutations will increase in several independent populations, hybrid vigor for late-life fitness is expected in offspring obtained in crosses among populations selected for early-life fitness traits. We tested longevity of both sexes, female fecundity and male reproductive behavior for hybrid vigor by comparing hybrid and nonhybrid short-lived populations. Hybrid vigor was confirmed for male virility, mating speed and copulation duration, and longevity of both sexes at late ages. In contrast to males, the results on female fecundity in short-lived populations did not support mutation accumulation as a genetic mechanism for the evolution of this trait. Contrary to the prediction of this hypothesis, male mating ability indices and female fecundity in long-lived populations exhibited hybrid vigor at all assayed age classes. We demonstrate that nonhybrid long-lived populations diverged randomly regarding female and male reproductive fitness, indicating that sexually antagonistic selection, when accompanied with genetic drift for female fecundity and male virility, might be responsible for overriding natural selection in the independently evolving long-lived populations.Serbian Ministry of Education, Science and Technological Development {[}173007

Modelling Creep (Relaxation) of the Urinary Bladder

We first present the results of an experiment in which the passive properties of the urinary bladder were investigated using strips of rabbit bladder. Under the assumption that the urinary bladder had orthopaedic characteristics, the strips were taken in the longitudinal and in the circumferential directions. The material was subjected to uniaxial tension, and stress-stretch curves were generated for various rates of deformation. We found that the rates did not have a significantly effect on the passive response of the material. Additionally, the stress-stretch dependence during relaxation of the material when exposed to isometric conditions was determined experimentally