Dragan Vasiljevic

Clinical Benefits of n-3 PUFA and ɤ-Linolenic Acid in Patients with Rheumatoid Arthritis

(1) Background: Marine n-3 polyunsaturated fatty acids (PUFA) and ɤ-linolenic acid (GLA) are well-known anti-inflammatory agents that may help in the treatment of inflammatory disorders. Their effects were examined in patients with rheumatoid arthritis; (2) Methods: Sixty patients with active rheumatoid arthritis were involved in a prospective, randomized trial of a 12 week supplementation with fish oil (group I), fish oil with primrose evening oil (group II), or with no supplementation (group III). Clinical and laboratory evaluations were done at the beginning and at the end of the study; (3) Results: The Disease Activity Score 28 (DAS 28 score), number of tender joints and visual analogue scale (VAS) score decreased notably after supplementation in groups I and II (p < 0.001). In plasma phospholipids the n-6/n-3 fatty acids ratio declined from 15.47 ± 5.51 to 10.62 ± 5.07 (p = 0.005), and from 18.15 ± 5.04 to 13.50 ± 4.81 (p = 0.005) in groups I and II respectively. The combination of n-3 PUFA and GLA (group II) increased ɤ-linolenic acid (0.00 ± 0.00 to 0.13 ± 0.11, p < 0.001), which was undetectable in all groups before the treatments; (4) Conclusion: Daily supplementation with n-3 fatty acids alone or in combination with GLA exerted significant clinical benefits and certain changes in disease activity.

Plasma Homocysteine Concentrations In Patients With Rheumatoid Arthritis

Abstract In this study, we investigated the concentration of serum homocysteine (Hcy) in patients with rheumatoid arthritis (RA) compared with the control group and the connection between homocysteine and parameters of inflammation and disease activity. Sixty RA patients and 20 healthy controls were included in the study, and clinical examination and investigation were performed during which disease activity was assessed. Peripheral blood samples were used for all of the assays. Levels of Hcy were 33% higher in the RA patients than in the control subjects (mean +/− SD 11.79±3.72 μmol/L versus 8.90±1.38 μmol/L; p< 0.01). A significant correlation was found between parameters of inflammation (C-reactive protein) and homocysteine in patients (r=0.322, p=0.012). Patients with high disease activity had a significantly greater increase in homocysteine (p<0.05). An increase in plasma homocysteine in RA patients is related to the parameters of inflammation and disease activity. Elevated Hcy levels occur commonly in patients with RA and may explain some of the increased cardiovascular mortality seen in RA patients.

Sociodemographic Characteristics Of The Over-The-Counter Drug Users In Serbia

RESEARCH ARTICLE Sociodemographic Characteristics Of The Over-The-Counter Drug Users In Serbia Mihailovic Natasa, Snezana Radovanovic, Dragan Vasiljevic, Sanja Kocic and Mihajlo Jakovljevic Department of Social Medicine, Institute of Public Health Kragujevac, Kragujevac, Serbia Department of Social Medicine, University of Kragujevac, Serbia, Faculty of Medical Sciences Department of Hygiene and Ecology, Faculty of Medical Sciences, University of Kragujevac, Serbia Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Serbia

The Effect of Sociodemographic Factors on the Patient Satisfaction with Health Care System

Abstract The goal of this paper is to determine the level of patient satisfaction with health care among adults in the Republic of Serbia and to analyze the correlation between the satisfaction and socio-demographic characteristics of the interviewees. The paper is based on the data provided by the National health survey of the Republic of Serbia. For the purposes of this paper, we used data on age and household of the people aged 19 and more. By eliminating the interviewees who were neither satisfied nor dissatisfied with the health care services, we obtained the sample containing 18.206 interviewees. Demographic characteristics and well-being index represented independent variables in the research. Dependent variable of the patient satisfaction was transformed into a binary variable by categorizing satisfied and very satisfied interviewees into one group and by placing dissatisfied and very dissatisfied interviewees into group of dissatisfied patients. The connection between satisfaction and predictors was examined using Chi-Square test and logistic regression. The percentage of the satisfied patients with health care was 72.9%. The satisfaction level was directly connected to age, gender, marital status, employment, region the interviewee comes from and well-being index. Patients who were more satisfied included older people, women, as well as married people, the unemployed and those living in the cities. The analysis of the financial situation shows that the poorest interviewees were the most satisfied with health care.

The Factors that Determine Reproductive Health Characteristics of Adolescents in Serbia

Abstract The aim of the work is to assess vulnerability degree of reproductive health in adolescent population in Serbia by analyzing their sexual behavior. The paper is based on data from a National health survey of the population in Serbia in 2013 (without Kosovo and Metohija region), conducted by the Ministry of Health of the Republic of Serbia. For the purposes of this study, the data used are referred to households and population of age 15 and over, so that the final number for analysis is a sample of 1722 respondents aged 15-24. The study included demographic characteristics of respondents (age, gender, settlement type, region) and the characteristics of reproductive health: sexual behavior, use of contraceptive protection, knowledge and attitudes towards HIV, protection of reproductive health. χ2 test was applied for testing differences in frequency of categorical variables. All results with a probability that equals to or is less than 5% (p≤0.05) are considered statistically significant. Among the respondents, there were more than half (53.5%) of sexually active adolescents. The highest percentage of them- 16.6% responded that they had first sexual intercourse at the age of 17. 53.4% of adolescents had sexual intercourse with one partner, 26.4% of respondents had sexual intercourse with two or more partners. The most commonly used contraceptive method was interrupted intercourse (coitus interruptus) with 34.7% of respondents.

The Impact of Socioeconomic Characteristics and Lifestyles on Vitamin D Deficit in Mentally Ill Patients

Abstract Mental illnesses put patients at high risk for vitamin D deficit. The aim of the research is to examine the impacts of socioeconomic characteristics and lifestyles on vitamin D deficiency in mentally diseased patients. In this crosssectional study we used blood samples from patients who were treated for mental disorders at Specialist-consultative unit of the Health Center and Clinical Center Kragujevac from May-June 2014. The study used a questionnaire for the assessment of vitamin D status. The study included 220 subjects with different types of mental disorders. Normal values of vitamin D were detected in 16% of patients whereas 64% of patients had vitamin D deficiency. The patients with vitamin D deficit were in average 3 years older than that but the difference is not statistically significant (p>0.05). The patients with vitamin D deficiency were primarily female (p=0.003), people with high-school education from urban environment who lived in bad life conditions (p>0.05). Between patients with and without vitamin D deficiency there is no difference in cigarette consumption, in the number of cigarettes per day, in alcohol usage, in coffee consumption and in nutrition. However, the patients without vitamin D deficiency spent more time outside; during the past year were more exposed to sun and during the past seven days spent more than 30 minutes a day exposed to sunlight (p<0.01). These facts indicate that there is a current need for further research in this area.

Possible Uses of Data from Hospital Discharge Reports

Abstract Almost all countries in the world keep some form of hospital discharge report (HDR). Although there are many variations, every report contains such data as patient demographics, the main cause of hospitalization, comorbidities, the length of stay in hospital and outcome. The advantages of using data obtained from HDRs are numerous: The data from HDRs are already collected in a designated centre and thus easily available and relatively cheap; HDRs contain information for many previous years; they are sometimes more reliable than data obtained through any other method; and finally, they provide a large and representative database. HDRs databases can be connected with other databases using a unified patient identification number. The limitations of using data obtained through HDRs are as follows: inconsistencies in defining and coding diagnoses and applied procedures, common underestimations of comorbidity, limited possible applications in specific studies and partial coverage of inpatient institutions. The prediction that in the future, a growing number of diagnostic and treatment procedures will be performed on an outpatient basis will also limit the use of HDRs. When electronic recordkeeping becomes a practice, we may assume that these data will no longer be needed. There is no perfect model for collection and processing data regarding hospitalized patients. HDRs, with their advantages and disadvantages, currently represent the best way to perceive the size, type, quality and efficiency of the health care services provided to patients at the secondary and tertiary level.

The Prevalence of Physical and Psychological Abuse and its Correlation with Depressive and Anxiety Symptoms among Students

Abstract Abuse in younger populations has been an issue of growing concern globally since youth already face various life situations that can heighten the occurrence of depression and anxiety disorders. The aim of this study was to determine the prevalence of physical and psychological abuse and its correlation with depressive and anxiety symptoms among students. This research was conducted as an epidemiological study of a sample of 1,940 university students using a standardized questionnaire by the World Health Organization. The survey, in addition to questions related to the abuse of youth, also included the Beck Depression Inventory and Beck Anxiety Inventory. Based on the results of this study, psychological abuse had a prevalence of 17.1%, while the prevalence of physical abuse was approximately 1.8%. Depressive symptoms were significantly related to physical (p<0.001) and psychological abuse (p<0.005), and anxiety symptoms were also significantly related to both physical (p=0.003) and psychological abuse (p<0.005). The results of this study indicated the importance of the early detection of abuse and depressive and anxiety symptoms among university students, which is essential for mental health promotion and the prevention of mental disorders.

Epidemiology of Suicidal Behaviour in Shumadia District, Serbia: A Fifteen-Year Retrospective Study

OBJECTIVE The purpose of this study is to analyze epidemiological characteristics of suicide, as well as to emphasize possible risk factors. METHODS This is a retrospective study, covering the period of fifteen years (1996-2010), which aims at discovering the relevant factors which have an influence on suicidal behaviour. This research uses the data from the documentation of the Ministry of Internal Affairs of Serbia and Police Department in Kragujevac, hospitalization reports of patients treated at Psychiatric Clinic of the Clinical Centre Kragujevac, as well as the medical records of patients treated at the Health Centre Kragujevac. χ2 test was applied to examine the influence of all selected factors on incidence of suicide and for this purpose SPSS statistical software package was used. RESULTS The analysis has shown that during the given period average suicide rate reached 11.8 per population of 100,000. The male to female suicide ratio of 3.6:1 obtained through this study suggests that men (78.4%) are more prone to suicide than women (21.6%). The highest number of suicides has been found within the age group of 65-year-olds (31.2%), while for the youngest age group (15-24 years) the lowest prevalence of 8.8% has been determined. In other words, the youngest subjects are 3.5 times less likely to commit suicide than the participants of the oldest age group. During the given period suicide was most often committed by married males and females with primary school education than by employed and retired people. The research has also revealed that most suicides came from urban areas (52.0%) and that the most common method of suicide is hanging (60.8%), followed by suicide by firearms, jumping from height, poisoning, and drowning. CONCLUSION In order to prevent suicide, it is essential to collect and analyze all information concerning suicide victims.

The Prevalence of Alcohol Consumption by Adolescents in Serbia and Its Correlation with Sociodemographic Factors – A National Survey

Abstract The aim of this study was to determine the prevalence of alcohol consumption among adolescents in Serbia and its association with sociodemographic characteristics. This paper is based on data from a national health survey of the population of Serbia in 2013 (no data for Kosovo and Metohija), conducted by the Ministry of Health of the Republic of Serbia. For the purposes of this study, data on households and individuals over 15 years of age were used; thus, the final sample for analysis included 858 patients (aged 15 to 19 years). Researchers used demographic characteristics (age, gender, type of home, region) and socio-economic characteristics (income per household member, the index of well-being, self-assessment of health, cigarette smoking, tendency towards psychological and physical violence) as the independent variables. A χ2 test was applied to test the differences in the frequencies of categorical variables. The correlations between alcohol consumption, as the dependent variable, and the independent variables (mentioned above) were tested by logistic regression. All results less than or equal to 5% probability (p ≤ 0.05) were considered statistically significant. The prevalence of alcohol consumption among adolescents in Serbia is 51.6%. Alcohol consumption is significantly associated with sex, type of home and the index of well-being (p < 0.05). The prevalence of alcohol consumption is higher in males (57.1%), in adolescents who come from urban areas (59.3%) and in adolescents who, according to the index of well-being, belong to the wealthiest financial category (23.9%).