Benefits of perindopril all along the cardiovascular continuum: the level of evidence.

Clinical efficacy of perindopril has been proved by using extensive clinical randomized studies in patients with hypertension, diabetes, cerebrovascular disease, stable coronary heart disease (CHD) and heart failure. Therefore, this ACE inhibitor has found its place in the leading clinical guidelines for the treatment of cardiovascular diseases. The cardioprotective effect of perindopril is independent of its antihypertensive effect with a positive safety profile. This is explained by its pharmacologic properties: long half-life, high lypophility and a high affinity for tissue ACE. ACE inhibition by perindopril causes two main factors: prevention of creation of angiotensin II and increase in bradykinin level. In that way, perindopril does not only lower the high blood pressure (BP), but it is also cardioprotective considering its antiatherosclerotic, antiinflammatory and antithrombotic effect. The use of perindopril in daily clinical practice needs to be based not only on antihypertensive effect, but also on the evaluation of total cardiovascular risk that is very high in patients with CHD, diabetes and cerebrovascular disease

PENALIZING MINORS WITHIN THE FRAMEWORK OF THE INTERNATIONAL HUMAN RIGHTS PROTECTION STANDARDS

In the legal system of the Republic of Serbia, the Act on Juvenile Criminal Offenders and Protection of Minors in Criminal Law366 (hereinafter: the Juvenile Offenders’ Act), fully regulates the criminal law status of juvenile delinquents. Thus, autonomous juvenile criminal law was established as an instrument for protecting the society from juvenile delinquency, but also as a set of rules on the criminal law protection of juveniles. Although the Juvenile Offenders’ Act envisages diversion measures, the judiciary’s reaction to juvenile delinquency most frequently entails educational measures, but there is also an exceptional possibility of punishing juvenile offenders. International law standards pertaining to the rights of children and minors mandate a restrictive approach to punishing juvenile offenders. Therefore, this paper will look at the conformity of the normative framework of juvenile prison in Serbian law with the guidelines provided in the international catalog of juvenile rights

The influence of administration of general intravenous anesthesia on the quality of colonoscopic procedure

Sve veća potreba za izvođenjem kolonoskopije u dijagnostičke ili terapijske svrhe nameće potrebu za usavršavanjem ove endoskopske procedure. Izvođenje kolonoskopije u opštoj, intravenskoj anesteziji, moglo bi u značajnoj meri olakšati njeno izvođenje, poboljšati podnošenje ove procedure od strane ispitanika i omogućiti otkrivanje većeg broja pacijenata sa potencijalno malignim bolestima debelog creva. Cilj ispitivanja je bio utvrditi da li primena opšte intravenske anestezije tokom kolonoskopije povećava broj totalnih kolonoskopija i skraćuje vreme intubacije cekuma, povećava broj viđenih patoloških procesa i smanjuje osećaj bola i učestalost neželjenih reakcija. Primena opšte intravenske anestezije značajno je povećala broj totalnih kolonoskopija u 94.3% ispitanika u odnosu na 78.7% totalnih kolonoskopija kontrolne grupe i skratila vreme intubacije cekuma, značajno je povećala broj viđenih patoloških promena u 46.7% ispitanika u odnosu na broj viđenih patoloških promena u 28.8% ispitanika kontrolne grupe i značajno je smanjila intenzitet bola i učestalost neželjenih reakcija. U kontrolnoj grupi ispitanika skalom bola nakon kolonoskopije ustanovljen je značajno veći intenzitet bola u poređenju sa ispitanicima ekperimentalne grupe. Na Likertovoj skali zadovoljstva ustanovljena je značajno bolja kontrola bola i lični stav lekara u ekperimentalnoj grupi, dok su poseta ustanovi i procedura, razumevanje procedure, tehnička veština lekara, lični stav medicinskih sestara i drugog tehničkog osoblja značajno bolje ocenjeni u kontrolnoj grupi. Od svih ispitivanih faktora na zadovoljstvo obe grupe pacijenata značajno su uticali: način izvođenja procedure, bol, uočene patološke promene i intubacija cekuma. U kontrolnoj grupi ispitanika između skale zadovoljstva i skale bola ustanovljena je značajna negativna korelacija. U kontrolnoj grupi se 80,1% pacijenata izjasnilo da bi ponovnu kolonoskopiju uradili u opštoj intravenskoj anesteziji u poređenju sa svim pacijentima eksperimentalne grupe koji ne bi menjali način izvođenja ponovne procedure. Primena opšte intravenske anestezije tokom kolonoskopije povećava broj totalnih kolonoskopija i uočenih patoloških promena, smanjuje učestalost i intenzitet neželjenih reakcija povećavajući zadovoljstvo pacijenata, što bi prevashodno moglo imati značaja u skriningu karcinoma debelog creva. Potrebno je proširiti ispitivanje primene opšte intravenske anestezije u drugim endoskopskim procedurama kako bi bila uvedena u svakodnevnoj kliničkoj praksi.An increasing need to perform colonoscopy for diagnostic or therapeutic purposes imposed the need for mastering this endoscopic procedure. Performing colonoscopy in general intravenous anesthesia could greatly ease the procedure, make it more comfortable for patients and it could enable detecting a higher number of patients with occult malignant diseases of the colon. The aim of this paper was to determine if the implementation of general intravenous anesthesia during colonoscopy increases the number of total colonoscopies and shortens the time of cecum intubation, increases the number of familiar pathological processes and decreases the sensation of pain as well as the frequency of side reactions. The implementation of general intravenous anesthesia has significantly increased the number of total colonoscopies in 94.3% of examined patients in relation to 78.7% of total colonoscopies of the control group and shortened the time of cecum intubation. It has significantly increased the number of familiar pathological changes in 46.7% of the patients in relation to the number of familiar pathological changes in 28.8% patients of the control group and significantly decreased pain intensity and the frequency of side reactions. A statistically greater pain intensity after colonoscopy was determined by the pain scale in the control group in comparison to the examinees of the experimental group. Likert satisfaction scale has shown that the experiment group assessed pain control and doctors’ opinion as significantly better, while the institution visits and the procedure, understanding the procedure, doctors’ technical skills, nurses’ and technical personnel’s personal opinions were assessed as significantly better in the control group. Out of all the examined factors on the satisfaction of both groups, the following ones had a significant inluence: the way the procedure was done, the level of pain, detected pathological changes and cecum intubation. A significanlty negative correlation was determined between the scale of satisfaction and the scale of pain in the control group. 80.1% of the control group patients stated that they would undergo a general anesthesia colonoscopy again in comparison to all the patients of the experimental group who would not change the way the procedure was previously done. The implementation of general intravenous anesthesia in the course of colonoscopy increases the number of total colonoscopies and detected pathological changes, decreases the frequency and intensity of side-effects therefore it enhances patients' sastisfaction, which could play a major role in colon cancer screening. It is necessary to extend the implementation of general intravenous anesthesia in other endoscopic procedures in order to introduce it in everyday clinical practice

The Methodological Issues of Census Ethnostatistics in the Light of Contemporary Migration Trends in Serbia

Zvanična etnostatistička nomenklatura u Srbiji iz 2011. godine prepoznaje ukupno 45 modaliteta nacionalne pripadnosti, regionalno opredeljenje, kao i grupnu kategoriju „ostale nacionalnosti“. Prateći ustavnu formulaciju etničkog koncepta državnosti zvanična statistika se vodi principom subjektivnog kriterijuma nacionalne identifikacije u popisima stanovništva. To znači da dobijeni podaci predstavljaju kvantifikaciju izjašnjavanja stanovništva prema identitetskom konceptu etničke, naspram građanske/državne pripadnosti stanovništva koja je prisutna u većini evropskih država. Iako je metodologija popisne statistike u Srbiji usmerena na dobijanje podataka o tzv. „etničkoj nacionalnosti“, u statističkim nomenklaturama po nacionalnoj pripadnosti možemo pronaći i modalitete kao što su Belgijanci, Francuzi, Danci, Šveđani, Italijani, Švajcarci, Finci, Norvežani ili Kinezi, a za koje se nacionalna identifikacija uglavnom utvrđuje prema državnom, a ne etničkom kriterijumu. To znači da se u istoj grupi nalaze podaci o etničkoj pripadnosti stanovništva na osnovu dva različita teorijska shvatanja etničkog identiteta, dok se obeležje „državljanstva“ u popisu stanovništva Srbije tretira kao pravna, a ne etnička kategorija. Prateći intenzitet i raznolikost migracionih trendova u poslednjem međupopisnom periodu, a prema usvojenim kriterijumima definicije stalnog stanovništva, realno je očekivati da je aktuelnim popisom obuhvaćen i određeni broj imigranata iz država u kojima se etnička obeležja tumače na različite načine što će dodatno otvoriti nova pitanja etničke kategorizacije u popisima stanovništva.The results of previous demographic research according to the ethnic characteristics of the population clearly point to the need for caution when using data from official ethnostatistics. Censuses and vital statistics form a quantitative basis for calculating ethno-demographic indicators whose interpretations can directly affect the creation of public policies aimed at the legal, political, economic and general social position, not only of members of minority ethnic groups, but also of the entire population. Although census ethnostatistics has been suspended in a large number of developed countries, there is a noticeable increase in interest in quantitative research on popu¬lation demographic characteristics relating to ethnicity. On the other hand, in countries that already have developed census ethnostatistics, there is reasonable doubt about the quality of the data, which leads to a review of the census methodology, starting with definitions and statistical categorisations, and ending with the methods of data collection and publication. So far, the results of population surveys according to ethnic characteristics provide enough space for various interpretations of the data because censuses often represent much more than a statistical record of social reality. This is especially noticeable in statistical categorisations based on ethnic characteristics, assigning censuses a significant role in constructing this reality that additionally reinforces the existing population divides. The collection of statistical data on the ethnic characteristics of the population of Serbia has a long tradition, primarily due to the historically inherited heterogeneous ethnic structure. In censuses during the first half of the 19th century, data on ethnic characteristics were collected only spo¬radically, but after Serbia had gained independence in 1878, ethnostatistics became one of the most important factors in political and overall social activity. Although a direct question about national (then ethnic) affiliation first appeared in the 1866 census, the opinion quickly prevailed that it was strongly influenced by the subjective understanding of ethnic identity, which was often equated with citizenship at that time. That is why language was given priority over ethno-national affiliation because, in addition to being of key importance for the creation of ethno-cultural and national identity, it also proved to be a statistically more objective indicator. From then until today, the ethnic structure of Serbia has changed significantly, but the motives for data collection have remained the same because the ethnostatistical census methodology at that time (as well as today) was based primarily on primor¬dial understandings of ethnicity. According to the current census methodology, it is possible to collect data on three ethno-cultural characteristics of the population: national affiliation (in the ethnic sense), mother tongue and religion. The obtained data can be considered a simple quantification of the subjective declaration of the population according to the ethno-identity concept. The citizenship characteristic in the Serbian census has the status of a legal rather than an ethnic category. The official ethnosta¬tistical nomenclatures used in the 2011 census included 45 modalities of nationality, regionally determined, as well as the group category “other nationalities”; and 36 modalities of the mother tongue, with the group category “other languages”. On the other hand, early statistical documentation points to the conclusion that, in Serbia, there was also an interest in data on the presence of foreigners who, like ethnic minorities, were viewed through the prism of “others”. During the 19th century, censuses periodically contained the question of “subservience”, which can be considered a forerunner of the modern interpretation of citizenship. During the Yu¬goslav phase of census statistics, the record of foreigners was an integral part of all eight censuses, and has remained so in all Serbian censuses from 2002 until today. According to the current census methodology, the Republic of Serbia intends to record permanently settled foreigners, foreigners granted temporary residence, asylum seekers and migrants without established status. The main aim of this research is to clarify the relationship between recording foreigners in Serbia and methodological solutions for collecting data on the ethnic characteristics of the population. Although the official ethnostatistical methodology in Serbia focuses primarily on obtaining data on “ethnic nationality”, the statistical nomenclature by nationality also includes mo¬dalities such as Belgians, French, Danes, Swedes, Italians, Swiss, Finns, Norwegians, and Chinese, whose national identification is mainly determined by the criterion of citizenship rather than ethnic identity. This means that the same group contains data on ethnicity based on two different theoretical understandings of ethnic identity. The statistical classification of the population by nationality gradually expanded after the Second World War. Since the 1981 census, there have been national modalities whose ethnicity is difficult to determine using the methodology applied, which casts doubt on the quality of the data and further complicates their usability. Obtained by the method of crossing data on citizenship, nationality and language affiliation, among other things, the research results show that a certain number of foreigners exercised the right not to declare their nationality. Therefore, the group of undeclared, undecided and unknown includes a relatively large number of citizens of Austria, China, Denmark, Switzerland, France and Great Britain. In these countries, data on ethnicity are not collected at all or are collected according to different definitions of nationality. Following immigration trends in the last inter-census period, it is realistic to expect that the next census will face a problem of ethnic identification of foreign citizens, especially immigrants from countries where ethnicity is understood differently. The presented research results show that the existing ethnostatistical census methodology hampers demographic research of foreigners in Serbia, but also reopens the dilemma of re-examining the quality and use of official ethnostatistical data, especially in the domain of public policies

Mother tongue as a determinant of ethnic identity in population censuses of Serbia

Information about linguistic affiliation was always collected according to the notion of mother tongue. Although in demography, mother tongue is seen as a more objective component of ethno-national affiliation, research results suggest significant disparities that are correlated with changes in ethno-statistical nomenclature and flotant behaviour of particular ethnic groups. The divergence between language and nationality in Serbia's population censuses unambiguously indicate that several ethnic communities can simultaneously declare the same mother tongue, but also that members of the same ethnic group can declare different mother tongues. The oscillations that occur in changes of the size of the population of certain ethno-linguistic modalities are milder than the variability of ethno-national modalities. The most expressive statistical imbalances were recorded in ethnic groups which were introduced into statistical nomenclature due to the targeted ethno-national stratification of the existing nations. Ethnic dissolution of the existing people simultaneously caused the process of linguistic stratification, by the principle of joining >> affiliate& mother tongue, most often of dialectical diversity of existing languages. Changes in the statistical nomenclature of languages that were adjusted with the initiation of new ethno-national modalities during the XX and the beginning of the XXI century serve as a statistical verification of the linguistic stratification of existing languages according to the principle of domination of the subjective understanding of the national identity. In terms of census statistics, this means that the processes of national homogenization, which were based on the language as a factor of integration during the nineteenth century, were replaced by modern processes of linguistic (primarily dialectical) homogenization based on an unstable and statistically unreliable trait of ethnicity, which makes it a peculiar absurdity, both in theory and in practice

Rational Utilisation of Antimicrobials - the Concept of Reserve Antibiotic

Neracionalna uporaba antimikrobnih lijekova vrlo je rasprostranjena, što dovodi do porasta rezistencije mikroorganizama, povećanih troškova i slabijeg ishoda liječenja. Stoga se rabe različite metode kontrole njihova korištenja. Do sada su najbolji rezultati postignuti koncepcijom "rezervnog antibiotika". U članku su opisane metode kontrole korištenja antimikrobnih lijekova s posebnim naglaskom na koncepciju "rezervnog antibiotika".The inappropriate use of antimicrobials is widespread with consequences as the rise of emergence of drug-resistant microorganisms, increased costs and worse outcoms of medical care. Therefore a number of methods for control of their utilization are used. So far the best results are reached with the concept of reserve antibiotic. In the article are described different methods for control of antimicrobials utilization with the special emphasis on the concept of reserve antibiotic