Influence of mental disorders on working ability assessment

Background/Aim. There is an increasing need for evaluation of working ability due to lower level of social protection of workers and growing number of patients with mental diseases in Bosnia and Herzegovina (B&H). The aim of this study was to establish the influence of mental diseases on the occurrence of disability of I and III categories in B&H during the period from January 1st 2005 to December 31st 2006. Methods. This study involved 1 792 examinees with the complete loss of working ability (I disability category) (n = 921). Disability category III consisted of persons with limited working ability (n = 871). The instruments of research in this multricentric and retrospective study were the forms P-6 and D-2 for the years of service in B&H, and the form IN for persons with years of service abroad and personal features questionnaire (EPQ). Results. The study included 1 494 men (78.5%) and 298 women (21.5%). Univariant analysis represented very high statistical significance (p = 0.001) concerning: age (χ2 = 65.428), years of service (χ2=28.438), drinking (χ2 = 33.234), smoking (χ2=70.880), father’s education (χ2 = 58.124), migrations (χ2 = 14.874), sick leave (χ2 = 29.190), medical treatment (χ2 = 95.073) and rehabilitation (χ2 = 29.453). Multivariant analysis represented the influence on disability category I by parameters such as: years of service, sick leave, psychoticism and depression (p = 0.001). Hospital treatment and fatigation had influence on disability in both groups. Mental diseases are the leading cause in disability category I in 14.98% and in disability category III in 9.3% persons. Leading diseases in both disability categories were depression and schizophrenia followed by alcoholism, anxiety, brain organ psychosyndrome (BOPS) and other diseases. Conclusion. The following parameters have highest influence on the disability category: the years of service, sick leave, psychoticism, depression, and long-lasting disease, medical treatments and fatigation on the disability category III

Механизми регенерације срца – шта можемо научити од зебрице

Nakon infarkta miokarda povređeno srce čoveka ne može da se regeneriše, već reaguje formiranjem fibrotičnog ožiljka i remodelovanjem miokarda, koji dovode do slabljenja njegove funkcije. Miokard sisara je dugo vremena smatran postmitotičkim i terminalno diferenciranim tkivom. Međutim, kardiomiociti sisara poseduju ograničenu sposobnost proliferacije. Njihova deoba je redak događaj i odvija se po veoma niskoj stopi, što svakako nije dovoljno da nadoknadi milione kardiomiocita trajno izgubljenih usled infarkta miokarda. Trenutno se u svetu razvijaju dve strategije za podsticanje regeneracije povređenog srca čoveka kako bi se povratile njegova struktura i funkcija. Jedna strategija podrazumeva naseljavanje oštećenog tkiva zdravim kardiomiocitima poreklom od indukovanih pluripotentnih ćelija, dok je cilj druge strategije aktivacija endogenih mehanizama regeneracije. Za razliku od čoveka, neki kičmenjaci imaju sposobnost regeneracije povređenih organa, uključujući srce. Životinja koja se najčešće koristi za proučavanje regeneracije srca je riba zebrica (Danio rerio). Pionirska studija o izuzetnom regenerativnom kapacitetu srca zebrice nakon amputacije dela komore objavljena je 2002. godine, nakon koje je usledilo mnoštvo publikacija o ćelijskim i molekularnim mehanizmima koji doprinose regenerativnom odgovoru. Regeneracija srca zebrice je rezultat strogo regulisane interakcije većeg broja procesa, uključujući inflamatorni odgovor, dediferencijaciju i proliferaciju kardiomiocita, neovaskularizaciju i reorganizaciju ekstraćelijskog matriksa. Regeneracija se može posmatrati kao uspavan proces u organima koji ne regenerišu i manipulacijom ovog procesa bi se mogla postići reaktivacija proliferacije u tim organima nakon povrede. Ispitivanje interakcije između pro-regenerišućih mehanizama i procesa koji utiču na regenerativni kapacitet treba da dovede do identifikacije faktora potrebnih za prevazilaženje blokade regeneracije. Na taj način bi se razvile nove strategije za indukciju proliferacije kardiomiocita i regeneraciju srca čoveka.Након инфаркта миокарда повређено срце човека не може да се регенерише, већ реагује формирањем фибротичног ожиљка и ремоделовањем миокарда, који доводе до слабљења његове функције. Миокард сисара је дуго времена сматран постмитотичким и терминално диференцираним ткивом. Међутим, кардиомиоцити сисара поседују ограничену способност пролиферације. Њихова деоба је редак догађај и одвија се по веома ниској стопи, што свакако није довољно да надокнади милионе кардиомиоцита трајно изгубљених услед инфаркта миокарда. Тренутно се у свету развијају две стратегије за подстицање регенерације повређеног срца човека како би се повратиле његова структура и функција. Једна стратегија подразумева насељавање оштећеног ткива здравим кардиомиоцитима пореклом од индукованих плурипотентних ћелија, док је циљ друге стратегије активација ендогених механизама регенерације. За разлику од човека, неки кичмењаци имају способност регенерације повређених органа, укључујући срце. Животиња која се најчешће користи за проучавање регенерације срца је риба зебрица (Danio rerio). Пионирска студија о изузетном регенеративном капацитету срца зебрице након ампутације дела коморе објављена је 2002. године, након које је уследило мноштво публикација о ћелијским и молекуларним механизмима који доприносе регенеративном одговору. Регенерација срца зебрице је резултат строго регулисане интеракције већег броја процеса, укључујући инфламаторни одговор, дедиференцијацију и пролиферацију кардиомиоцита, неоваскуларизацију и реорганизацију екстраћелијског матрикса. Регенерација се може посматрати као успаван процес у органима који не регенеришу и манипулацијом овог процеса би се могла постићи реактивација пролиферације у тим органима након повреде. Испитивање интеракције између про-регенеришућих механизама и процеса који утичу на регенеративни капацитет треба да доведе до идентификације фактора потребних за превазилажење блокаде регенерације. На тај начин би се развиле нове стратегије за индукцију пролиферације кардиомиоцита и регенерацију срца човека.Knjiga sažetaka: Treći Kongres biologa Srbije, Zlatibor, Srbija 21 - 25. 9. 2022

Dr Atanasije Puljo - pionir srpske stomatologije

This paper describes the life and work of Dr. Atanasije Puljo (1878-1944). He was a volunteer in the Balkan wars, an active participant in the First World War; he was the first who noted the importance of team-work of a dentist and a surgeon in the care of jaw and facial injuries. He established primacy in this field, as he came up with this brilliant idea three years before other colleagues. His method of treatment of the upper jaw neglected fractures, called the Balkan method, was recognized worldwide. Dr. Puljo is the pioneer of dental radiology in Serbia, founder of the Odontology Clinic of the Medical Faculty and main supporter of the establishment of the School of Dentistry. Merits of Dr. Atanasije Puljo, medical practitioner with a broad knowledge in different fields, remain within the academic institution that was founded by this pioneer of dentistry in Serbia.Dr Atanasije Puljo (1878-1944) bio je dobrovoljac u balkanskim ratovima, aktivni učesnik u Prvom svetskom ratu i prvi koji je uočio značaj zajedničkog rada zubnog lekara i hirurga u zbrinjavanju ranjenika s povredama vilica i lica. Na taj način zauzeo je primat u ovoj oblasti i tri godine pre drugih došao na ovu genijalnu zamisao. Svetski je priznata njegova metoda lečenja zastarelih preloma gornje vilice, nazvana 'balkanska metoda'. Dr Puljo je pionir stomatološke rendgenologije u Srbiji, osnivač Odontostomatološke klinike Medicinskog fakulteta i idejni začetnik Stomatološkog fakulteta u Beogradu. Zasluge dr Atanasija Pulje, sveobuhvatnog medicinara, ostaju utemeljene u instituciji fakulteta koju je pionirski začeo ovaj rodonačelnik stomatologije u Srbiji

The Life and Work of Ksenija Atanasijević (1894-1981) - Psychology and Anthropology as the Inevitability and Necessity of Philosophy

Ksenija Atanasijević (1894-1981) was the first woman in Serbia to obtain a Ph. D. in philosophy. Going through numerous psychological metamorphoses in her lifetime and confronted with numerous challenges, Ksenija Atanasijević developed a specific philosophical-psychological system of consolation prominently featuring the concepts of happiness, bliss, moderation, courage and wisdom. Modifying the original teachings of Democritus and Epicurus, Ksenija Atanasijević developed a distinctive anthropology based on confrontation with but equally the overcoming of obstacles, both internal (spiritual) as well as external ones. The philosopheress developed a reflexive and indeed metaphysical defensive psychotherapeutical skill at the root of which was cleansing the soul, as well as dedication to the realm of fancy, fantasy and imagination. Ksenija Atanasijević also had precious literary talent which was best expressed in her analyses of the poetry and prose of great Serbian writers (Pandurović, Njegoš, Nastasijević, etc.). It is quite certain that this, with Anica Savić-Rebac, definitely greatest Serbian philosopheress, through personal suffering, creative solitude and shrouded desperation built an utterly authentic and harmonious system of philosophical comfort

The Life and Work of Ksenija Atanasijević (1894-1981) - Psychology and Anthropology as the Inevitability and Necessity of Philosophy

Ksenija Atanasijević (1894-1981) was the first woman in Serbia to obtain a Ph. D. in philosophy. Going through numerous psychological metamorphoses in her lifetime and confronted with numerous challenges, Ksenija Atanasijević developed a specific philosophical-psychological system of consolation prominently featuring the concepts of happiness, bliss, moderation, courage and wisdom. Modifying the original teachings of Democritus and Epicurus, Ksenija Atanasijević developed a distinctive anthropology based on confrontation with but equally the overcoming of obstacles, both internal (spiritual) as well as external ones. The philosopheress developed a reflexive and indeed metaphysical defensive psychotherapeutical skill at the root of which was cleansing the soul, as well as dedication to the realm of fancy, fantasy and imagination. Ksenija Atanasijević also had precious literary talent which was best expressed in her analyses of the poetry and prose of great Serbian writers (Pandurović, Njegoš, Nastasijević, etc.). It is quite certain that this, with Anica Savić-Rebac, definitely greatest Serbian philosopheress, through personal suffering, creative solitude and shrouded desperation built an utterly authentic and harmonious system of philosophical comfort

Serbian translation of the 20-item Toronto alexithymia scale: Psychometric properties and the new methodological approach in translating scales

Introduction Since inception of the alexithymia construct in 1970's, there has been a continuous effort to improve both its theoretical postulates and the clinical utility through development, standardization and validation of assessment scales. Objective The aim of this study was to validate the Serbian translation of the 20-item Toronto Alexithymia Scale (TAS-20) and to propose a new method of translation of scales with a property of temporal stability. Methods The scale was expertly translated by bilingual medical professionals and a linguist, and given to a sample of bilingual participants from the general population who completed both the English and the Serbian version of the scale one week apart. Results The findings showed that the Serbian version of the TAS-20 had a good internal consistency reliability regarding total scale (α=0.86), and acceptable reliability of the three factors (α=0.71-0.79). Conclusion The analysis confirmed the validity and consistency of the Serbian translation of the scale, with observed weakness of the factorial structure consistent with studies in other languages. The results also showed that the method of utilizing a self-control bilingual subject is a useful alternative to the back-translation method, particularly in cases of linguistically and structurally sensitive scales, or in cases where a larger sample is not available. This method, dubbed as 'forth-translation', could be used to translate psychometric scales measuring properties which have temporal stability over the period of at least several weeks

Kvalitet života povezan sa zdravstvenim stanjem studenata medicine - komparativna studija

Background/Aim. Previous studies on medical students' subjective perception of health and health-related quality of life (HRQoL) showed inconclusive results. Moreover, there are no published studies to compare HRQoL of medical students to non-medical university students. The aim of the study was to assess subjective perception of health-related quality of life (HRQoL) in medical students' sample, to compare it with non-medical university stu-dents and to ascertain predictors of better perception of HRQoL in medical students. Methods. Scores of all domains on the Mental and Physical Component Summary subscales and total score of the Short Form Health Survey (SF-36), used for assessment of HRQoL in samples of 561 medical and 332 non-medical university students were assessed and compared. In addition, linear regression to identify predictors of better perception of mental and physical components of HRQoL and overall HRQoL in the sample of medical students was used. The dependant variables were subscores and total score with the SF- 36, and independent variables were certain sociodemographic and academic characteristics of the students. Results. Medical students had statistically significantly higher scores on the Mental Component Summary and total SF-36 score compared to non-medical students. Linear regression analysis demonstrated that higher scores of Physical Component Summary were associated with age, male sex and the year of studies. The Mental Component Summary were associated with age, male sex, the year of studies and marital status. The total SF-36 score was associated with age, male sex and the year of studies. Conclusion. Medical students perceive their health much better than other university students do, but female, older and second grade medical students have worse perception of their HRQoL. Those points should be potential target areas for specific prevention and treatment in order to achieve better HRQoL.Uvod/Cilj. Dosadašnje studije subjektivne percepcije zdravlja i kvaliteta života povezanog sa zdravstvenim stanjem (HRQoL) studenata medicine pokazale su kontradiktorne rezultate. Štaviše, ne postoje objavljene studije koje su poredile HRQoL studenata medicine i studenata ne- medicinskih fakulteta. Cilj ove studije bio je da se proceni subjektivna percepcija HRQoL na uzorku studenata medicine, da se uporedi sa percepcijom HRQoL studenata ne- medicinskih fakulteta i da se utvrde prediktori bolje percepcije HRQoL kod studenata medicine. Metode. Uzorak za istraživanje obuhvatio je 561 studenta medicine i 332 studenta ne-medicinskih fakulteta Univerziteta u Beogradu. Istraživanje je obavljeno uz pomoć Short Form Health Survey (SF-36) upitnika koji procenjuje mentalnu i fizičku komponentu, kao i ukupan skor subjektivne procene kvaliteta života vezanog za zdravstveno stanje. Upoređeni su skorovi sa zbirne skale i supskala dve grupe studenata. Pored toga, korišćena je i linearna regresija da bi se procenili prediktori boljeg sagledavanja ukupnog skora i mentalne i fizičke komponente HRQoL na uzorku studenata medicine. Zavisne varijable bile su supskorovi i ukupan skor sa SF- 36 upitnika, a nezavisne varijable sociodemografske i akademske karakteristike ispitanika. Rezultati. Studenti medicine imali su statistički značajno više skorove na supskali mentalnog zdravlja i na ukupnom skoru SF-36 upitnika u odnosu na studente ne-medicinskih fakulteta. Linearna regresija pokazala je da su viši skorovi fizičke komponente povezani sa godinama starosti, muškim polom i godinom studija; viši skorovi mentalne komponente povezani sa godinama starosti, muškim polom, godinom studija i bračnim statusom. Ukupan SF-36 skor povezan je sa godinama starosti, muškim polom i godinom studija. Zaključak. Studenti medicine gledaju na svoje zdravstveno stanje mnogo bolje nego studenti ne-medicinskih fakulteta. Ipak, devojke, stariji studenti i studenti druge godine medicine imaju lošiju percepciju svog kvaliteta života koji se vezuje za zdravlje. Ovo bi trebalo da budu fokusi za specifičnu prevenciju i eventualnu terapiju u cilju postizanja boljeg kvaliteta života studenata medicine

Volumetric Analysis of Amygdala, Hippocampus, and Prefrontal Cortex in Therapy-Naive PTSD Participants

Objective. In our study we have hypothesized that volume changes of amygdala, hippocampus, and prefrontal cortex are more pronounced in male posttraumatic stress disorder participants. Material and Methods. We have conducted a study of 79 male participants who underwent MRI brain scanning. PTSD diagnosis was confirmed in 49 participants. After MRI was taken all scans were software based volume computed and statistically processed. Results. We found that left amygdala is the most significant parameter for distinction between PTSD participants and participants without PTSD. There were no significant differences in volumes of hippocampi and prefrontal cortices. Roc curve method outlined left amygdala AUC = 0.898 (95% CI = 0.830-0.967) and right amygdala AUC = 0.882 (95% CI = 0.810-0.954) in the group of PTSD participants which makes both variables highly statistically significant. Conclusion. The present investigation revealed significant volume decrease of left amygdala in PTSD patients. Concerning important functions of the amygdala and her neuroanatomical connections with other brain structures, we need to increase number of participants to clarify the correlation between impared amygdala and possible other different brain structures in participants with PTSD

Sistemi zdravstvene zaštite

The health system is one of the most complex systems in any country. Each state has an obligation to take care and care about the health of its population. The health care system includes the health infrastructure that provides a range of programs and services, and provides health care to individuals, families and communities. The health system must ensure the physical, geographical and economical accessiblity and affordability of integrated and quality health care. It should also provide for the development of health personnel, finance sustainability, decentralization of management and financing of health care and placing the citizens at the centers of the health system. The purpose of the health care system is the preservation and improvement of human health by providing health services, modern as well as traditional medicine, in an efficient manner and at the same time accessible and acceptable to the people. Due to its importance and impact on the population of each country, as well as its large economic impact, the government implemented a series of measures in planning and managing the health care system to ensure stable funding and rational and a quality health care delivery system, and all this in order to provide within the available resources a basic health care. In all the countries, the aging of the population and the introduction of new and expensive technologies present a constantly increasing cost of health care delivery. Modern health care systems differ from each other mainly in the methods of raising funds for health care, as well as in methods of payment for the service providers in the health sector. Problems of health care systems rarely, if ever, can be solved forever. As countries develop, their health care systems must respond to new challenges.Zdravstveni sistem predstavlja jedan od najsloženijih sistema u bilo kojoj državi. Svaka država ima obavezu da vodi računa i brine o zdravstvenom stanju svog stanovništva. Sistem zdravstvene zaštite obuhvata zdravstvenu infrastrukturu koja obezbeđuje spektar programa i usluga i pruža zdravstvenu zaštitu pojedincima, porodicama i zajednici. Zdravstveni sistem mora da osigura fizički, geografski i ekonomski dostupnu i pristupačnu, integrisanu i kvalitetnu zdravstvenu zaštitu. Takođe, treba da obezbedi razvoj zdravstvenih kadrova, održivost finansiranja, decentralizaciju upravljanja i finansiranja zdravstvene zaštite i postavljanje građanina u centar zdravstvenog sistema. Svrha sistema zdravstvene zaštite je očuvanje i unapređenje zdravlja ljudi obezbeđivanjem zdravstvenih usluga stanovništvu kako moderne, tako i tradicionalne medicine na efikasan način, a koje su u isto vreme dostupne i prihvatljive ljudima. S obzirom na njegov značaj i uticaj na zdravstveno stanje stanovništva svake države, kao i zbog velikog ekonomskog uticaja, država sprovodi niz mera u planiranju i upravljanju zdravstvenim sistemom kako bi obezbedila stabilno finansiranje i racionalan i kvalitetan sistem pružanja zdravstvene zaštite, a sve to u cilju da se u okviru raspoloživih sredstava stanovništvu obezbedi osnovna zdravstvena zaštita. U svim zemljama je zbog starenja stanovništva i uvođenja novih i skupih tehnologija prisutno stalno povećanje troškova pružanja zdravstvene zaštite. Savremeni sistemi zdravstvene zaštite razlikuju se međusobno najviše u metodama prikupljanja sredstava za zdravstvenu zaštitu, kao i u načinima plaćanja davaoca usluga u zdravstvu. Problemi sistema zdravstvene zaštite retko, ili nikada, ne mogu se rešiti zauvek. Kako se zemlje razvijaju, tako i njihovi sistemi zdravstvene zaštite moraju da odgovore na nove izazove