Demographic and socioeconomic factors associated with cervical cancer screening among women in Serbia

ObjectivesEffective reduction of cervical cancer incidence and mortality requires strategic measures encompassing the implementation of a cost-effective screening technology. Serbia has made significant strides, introducing organized cervical cancer screening in 2012. However, various impediments to screening implementation persist. The aim of the study was to estimate the socioeconomic factors associated with cervical cancer screening among women in Serbia.MethodsData from 2019 National Health Survey of the population of Serbia were used in this study. The study is cross sectional survey on a representative sample of the population of Serbia. Present total number of participants analyzed in survey 6,747.ResultsIn Serbia, 67.2% of women have done a Pap test at any time during their lives, of which 46.1% of women have undergone cervical cancer screening in the past 3 years. About a quarter of women have never undergone a Pap test in their life (24.3%). The probability of never having a Pap test have: the youngest age group (15–24 years) is 1.3 times more likely than the oldest age group (OR = 1.31), unmarried women 0.3 times more often than married women (OR = 0.37), respondents with basic education 0.9 times more often than married women (OR = 0.98), the women of lower socioeconomic status 0.5 times more often than respondents of high socioeconomic status (OR = 0.56).ConclusionEnhancement of the existing CCS would be the appropriate public health approach to decrease the incidence and mortality of cervical cancer in the Republic of Serbia

Fractional flow reserve of intermediate lesions on collateral donor coronary arteries after myocardial infarction

Fractional flow reserve (FFR) is the gold standard for the functional assessment of coronary arteries. The aim of this study was to evaluate the relation between angiography, QCA and FFR in borderline lesions on collateral donor coronary arteries. In addition, FFR is compared with the angiographic appearance of collaterals to infarction-related arteries and echocardiographically assessed viability of infarct related the LV wall. In 60 patients with previous IM and occluded IRA, functional assessment of borderline coronary stenosis (30-70% DS) on collaterals donor artery was performed. We have not found statistically significant differences in these parameters between groups with different angiographic appearances of collaterals and different viability of distal myocardium. However, we found higher FFR values in diabetic patients (p=0.018). Higher FFR values in diabetic patients reveal the negative effects of diabetes on collateral growth and myocardial viability

Fractional flow reserve in patients with intermediate values of Duke Treadmill Score and borderline coronary lesions

Despite the wide usage of exercise ECG tests and Duke Treadmill Score (DTS) in clinical practice, no comparison between this scoring system and Fractional Flow Reserve (FFR) has yet been made, particularly in cases of angiographically verified borderline lesions. Thirty patients with single coronary lesions and angiographically assessed borderline stenosis (between 30-70%) and previously calculated intermediate values of DTS between -10 to +4 were examined using FFR. Adequate specificity and sensitivity (0.769 and 0.556, respectively) were in a more narrow range of -0.5 to -10. Sex and age did not have an influence on the DTS values. There was a correlation between the values of FFR and age (r=0.395, p=0.031) and between angiographic assessment of stenosis and quantitative coronary angiography (QCA) (r=0.648, p<0.0001). In the study population, a decision on revascularization could not be based solely on angiographic or QCA assessment of the artery or on the values of DTS

Predicting the survival probability of functional neuroendocrine tumors treated with peptide receptor radionuclide therapy: Serbian experience

IntroductionPeptide receptor radionuclide therapy (PRRT) is a treatment option for well-differentiated, somatostatin receptor positive, unresectable or/and metastatic neuroendocrine tumors (NETs). Although high disease control rates seen with PRRT a significant number NET patients have a short progression-free interval, and currently, there is a deficiency of effective biomarkers to pre-identify these patients. This study is aimed at determining the prognostic significance of biomarkers on survival of patients with NETs in initial PRRT treatment.MethodologyWe retrospectively analyzed 51 patients with NETs treated with PRRT at the Department for nuclear medicine, University Clinical Center Kragujevac, Serbia, with a five-year follow-up. Eligible patients with confirmed inoperable NETs, were retrospectively evaluated hematological, blood-based inflammatory markers, biochemical markers and clinical characteristics on disease progression. In accordance with the progression og the disease, the patients were divided into two groups: progression group (n=18) and a non-progression group (n=33). Clinical data were compared between the two groups.ResultsA total of 51 patients (Md=60, age 25-75 years) were treated with PRRT, of whom 29 (56.86%) demonstrated stable disease, 4 (7.84%) demonstrated a partial response, and 14 (27.46%) demonstrated progressive disease and death was recorded in 4 (7.84%) patients. The mean PFS was a 36.22 months (95% CI 30.14-42.29) and the mean OS was 44.68 months (95% CI 37.40-51.97). Univariate logistic regression analysis displayed that age (p&lt;0.05), functional tumors (p&lt;0.05), absolute neutrophil count (p&lt;0.05), neutrophil-lymphocyte ratio-NLR (p&lt;0.05), C-reactive protein-CRP (p&lt;0.05), CRP/Albumin (p&lt;0.05), alanine aminotransferase-ALT (p&lt;0.05), were risk factors for disease progression. Multivariate logistic regression analysis exhibited that functional tumors (p&lt;0.001), age (p&lt;0.05), CRP (p&lt;0.05), and ALT (p&lt;0.05), were independent risk factors for the disease progression in patients with NETs. Tumor functionality was the most powerful prognostic factor. The median PFS (11.86 ± 1.41 vs. 43.38 ± 3.16 months; p=0.001) and OS (21.81 ± 2.70 vs 53.86 ± 3.70, p=0.001) were significantly shorter in patients with functional than non-functional NETs respectively.ConclusionThe study’s results suggest that tumor functionality, and certain biomarkers may serve as prognostic survival indicators for patients with NETs undergoing PRRT. The findings can potentially help to identify patients who are at higher risk of disease progression and tailor treatment strategies accordingly

Socioeconomic inequalities in the use of dental health care among the adult population in Serbia

ObjectivesThe aim of this paper is to assess the association of demografic and socioeconomic determinants with utilization of dental services among Serbian adults.Materials and methodsThe study is a part of the population health research of Serbia, conducted in the period from October to December 2019 by the Institute of Statistics of the Republic of Serbia in cooperation with the Institute of Public Health of Serbia “Dr. Milan JovanovićBatut” and the Ministry of Health of the Republic of Serbia. The research was conducted as a descriptive, cross-sectional analytical study on a representative sample of the population of Serbia. For the purposes of this study, data on the adult population aged 20 years and older were used.ResultsMen were approximately 1.8 times more likely than women to not utilize dental healthcare services (OR = 1.81). The likelihood of not utilizing dental healthcare protection rises with increasing age, reaching its peak within the 65–74 age range (OR = 0.441), after which it declines. Individuals who have experienced marital dissolution due to divorce or the death of a spouse exhibit a higher probability of not utilizing health protection (OR = 1.868). As the level of education and wealth diminishes, the probability of abstaining from health protection increases by 5.8 times among respondents with an elementary school education (OR = 5.852) and 1.7 times among the most economically disadvantaged respondents (OR = 1.745). Regarding inactivity, respondents who are not employed have a 2.6-fold higher likelihood of not utilizing oral health care compared to employed respondents (OR = 2.610).ConclusionThe results suggest that individual sociodemographic factors influence utilization of dental services by Serbian adults and confirmed the existence of socioeconomic disparities

Attitudes of Primary School Teachers Toward Inclusive Education

Background: The aims of our study are related to examining the relevance of teachers' attitudes toward the implementation of inclusive education. In addition, its subject is related to the implications on inclusive education policies, limitations of the existing study along with the recommendations for our future research endeavors. Methods: The research is a cross-sectional study type. The sample included 64 primary school teachers in the lower grades of primary school (grades 1–4), selected by using simple random sampling, in three primary schools on the territory of Belgrade, Serbia in 2021 (26, 17, and 21 primary school teachers). The Questionnaire for Teachers, which was used as a research instrument, was taken from the Master's Thesis Studen Rajke, which was part of the project “Education for the Knowledge Society” at the Institute for Educational Research in Belgrade. Dependent variables measured in the study referred to the attitudes of primary school teachers toward inclusive education. Categorical variables are represented as frequencies and the Chi-square test was used to determine if a distribution of observed frequencies differed from the expected frequencies. Results: One in three teachers (32.8%) thought that inclusion was useful for children with disabilities (29.7%), of them thought that schools did not have the conditions for inclusive education, whereas one in four teachers (25.0%) believed that inclusion was not good. No statistically significant differences were found in the attitudes of professors, when observed in terms of their gender, age and length of service. Conclusion: Investing more resources and time in developing and implementing special education policies can promote successful inclusive education

Modern imaging techniques of vulnerable atherosclerotic plaque on coronary arteries

The availability of powerful imaging techniques has the potential to improve our understanding of the biology of the vulnerable plaque in atherosclerosis. Vascular remodelling manifests as either expansive or restrictive, and changes in the vessel wall composition (hypertrophy or hypotrophy) are common to all vascular pathologies. Enzymes involved in dissolving the extracellular matrix and proliferating cells comprising the neointima can be targeted for imaging. Inflammation is an important component of atherosclerosis. A positron-labelled probe, 18F-FDG, is widely available for tumour imaging and shows a promise as a marker of inflammatory activity of atherosclerotic plaque and plaque burden. Single photon-labelled probe that binds the LOX-1 LDL receptor on macrophages for oxidized LDL shows a promise as an agent for imaging inflammation in atherosclerosis. Radiolabelled MPIs that target both inflammation and remodelling show a promise in preclinical experiments. Nanoparticles with paramagnetic properties have been designed to target angiogenesis, which is an important process in advanced atherosclerotic plaque leading to intraplaque hemorrhage and instability. Ironbased particles, USPIOs, are taken up by macrophages in atheroma, and USPIO-MRI has the potential to become an approach to image inflamed and active atherosclerotic plaques. Despite the current technological limits, we believe that these imaging methods of atherosclerotic plaques are very promising approaches for being tested in clinical studies

Clinical Usefulness of 99mTc-HYNIC-TOC and 131I-MIBG Scintigraphy in the Evaluation of Adrenal Tumors

Disorders and morphological abnormalities affecting the adrenal gland, could lead to profound clinical consequences, owing to its biochemical structure-activity and morphological characteristics

Agreement between admission and discharge diagnoses: Analysis by the groups of international classification of diseases, 10th revision

© 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. Admission diagnosis represents the diagnosis of an illness, injury or condition due to which a patient is referred to hospital to be admitted. Discharge diagnosis represents the main reason of illness or condition due to which a patient is admitted. The aim of this study was to analyze the agreement between admission diagnostic groups and discharge diagnostic groups of patients in the Clinical Center Kragujevac in the period from January 1, 2006 to December 31, 2013 on the basis of the hospitalization report. Methods. From the basic set of reports, 5% of random samples were singled out and they contained 20,422 reports. Out of the given number of reports, 18,173 hospitalization reports were complete and then further analyzed in the paper. Admission diagnostic groups given by the primary care doctor were compared with discharge diagnostic groups filled out by the practicing physician in the hospital ward from which a patient was discharged. The agreement of these two diagnostic groups was an indication of the high-quality performance of the primary care doctor. Agreement analysis was conducted using Cohen’s Kappa statistics. Results. Agreement analysis showed that the values of the Kappa coefficient for the five leading admission diagnostic groups were in the range of κ = 0.61 to κ = 0.94. The values of the Kappa coefficient for the five most common discharge diagnostic groups were in the range of κ = 0.55 to κ = 0.81. Conclusion. Hospitalization report is a reliable individual report on inpatient care, so it could be used in determining the degree of agreement between admission diagnostic groups and discharge diagnostic groups

The prevalence and socioeconomic correlates of depressive and anxiety symptoms in a group of 1,940 Serbian university students

© 2016, Institut za Vojnomedicinske Naucne Informacije/Documentaciju. All rights reserved. Background/Aim. Mental health of university students is under increasing concern worldwide, because they face challenges which predisposes them to depression and anxiety. The aim of this study was to identify demographic and socioeconomic variables associated with depressive and anxiety symptoms among university students. Methods. This cross-sectional study on 1,940 university students was performed using a questionnaire including demographic and socioeconomic variables, Beck Depression Inventory and Beck Anxiety Inventory. Results. The prevalence of depressive symptoms in students was 23.6%, while the prevalence of anxiety symptoms was 33.5%. The depressive symptoms were significantly related to the study year (p = 0.002), type of faculty (p = 0.014), satisfaction with college major choice (p < 0.001), satisfaction with grade point average (p < 0.001). Female students (odds ratio – OR = 1.791, 95% confidence interval – CI = 1.351–2.374), older students (OR = 1.110, 95% CI = 1.051-1.172), students who reported low family economic situation (OR = 2.091, 95% CI = 1.383–3.162), not owning the room (OR = 1.512, 95% CI = 1.103–2.074), dissatisfaction with graduate education (OR = 1.537, 95% CI = 1.165–2.027) were more likely to show depressive symptoms. The anxiety symptoms were significantly related to study year (p = 0.034), type of faculty (p < 0.001), family economic situation (p = 0.011), college residence (p = 0.001) satisfaction with the college major choice (p = 0.001), and satisfaction with graduate education (p < 0.001). Female students (OR = 1.901, 95% CI = 1.490–2.425), and students who reported parents high expectations of academic success (OR = 1.290, 95% CI = 1.022–1.630) were more likely to show anxiety symptoms. Conclusion. This is one of the largest study examining mental disorders in a sample of university students in Serbia. These findings underscore the importance of early detections of mental problems and prevention interventions in university students