Snezana Radovanovic

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 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 efficacy of moxifloxacin in patients with bacterial keratitis

Background/Aim. Keratitis is a sociomedical problem of moderately developed countries. including Serbia, too. The incidence of bacterial keratitis in the world is about 20% in relation to all keratitis, but its frequency in Serbia is still not known. Bearing in mind the complications in the front segment of the eye after bacterial keratitis (ulcer, neovascularization, fibrosis) and decline in visual acuity, it was necessary to assess the efficacy of local therapy by moxifloxacin which will shorten the healing time and reduce complications. The aim of the study was to analyze the efficiency of shortening the treatment of bacterial keratitis with moxifloxacin. Methods. The study was designed as prospective, randomized, double-blind study. The study included 30 patients with diagnosed keratitis and locally applied antibiotic moxifloxacin, and 60 patients in a control group, with locally applied artificial tears. All participants were subjected to complete clinical ophthalmologic analysis (2015/16), for a period of 1–15 days after the application of therapies (healing time of corneal pathology). The following was determined in all patients: degree of hyperemia, degree of epithelial defect, level of corneal sensitivity, level of tear secretion and tear quality, degree of conjunctival secretion, degree of neovascularisation and corneal scarring, degree of visual acuity, score of subjective symptomatology and correlation of ophthalmological findings and subjective symptoms. Results. There was a statistically significant difference in times of therapeutic efficacy/clinical response between the study group patients who received moxifloxacin and the control group patients who received arteficial tears. Conclusion. Local application of moxifloxacin had therapeutic effect (total benefit) both in terms of the effective shortening of the healing time and also the reduction of the complications of bacterial keratitis, without unwanted effects.

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.

Socioeconomic inequalities and non-communicable diseases in Serbia: National health survey

Background/Aim. Non-communicable diseases (NCDs) are a major public health challenge worldwide. Although they are preventable, NCDs are the major global causes of morbidity and mortality, absenteeism, disability and premature death. The aim of this study was to examine socioeconomic inequalities in the prevalence of non-communicable diseases in Serbia. Methods. Data from the 2013 National Health Survey of the population of Serbia was used in this study. There were 13,765 adults interviewed, aged ≥ 20 years. We used multivariate logistic regression analyses with demographic and socioeconomic determinants of health as independent variables and prevalence of non-communicable diseases as a dependent variable. The minimum level of significance was p < 0.05. Results. Hypertension was the most prevalent NCDs (36.1%). The prevalence of multimorbidity was 47.1%. Multivariate logistic regression analysis showed that gender, age, place of residence, employment status and education were associated with the presence of NCDs. The odds ratio (OR) for age was 1.074 [95% confidence interval (CI) : 1.070–1.077). Women were at a higher risk of NCDs by 58.9% when compared to men (OR = 1.589; 95% 95% CI : 1.467–1.726). Respondents who lived in the rural areas were at a higher risk for NCDs by 14.1% compared to those who lived in urban areas (OR = 1.141; 95% CI : 1.047– 1.244). Odds ratio for unemployment was 1.227 (95% CI: 1.118–1.346). Respondents with primary education were at a higher risk for chronic diseases by 47.1% (OR = 1.471; 95% CI : 1.281–1.687) while those with secondary school were at a higher risk by 27.7% (OR = 1.277; 95% CI : 1.142–1.428) compared to respondents who had higher education. When it comes to Wealth Index, univariate logistic regression analysis showed that respondents who belonged to the poor and middle classes were at a higher risk for NCDs (OR = 2.031; 95% CI : 1.819–2.267; OR = 1.473; 95% CI : 1.343– 1.615) compared to respondents who belonged to the rich class. Multivariate logistic regression analysis did not show statistically significant correlations between the Wealth index and NCDs. Conclusion. Socioeconomic inequalities in health status are the major challenge and should be a target of national health policy in Serbia, not only because they represent social injustice but also because solving the health problems of underprivileged groups of the population can influence improvement of health status of the population as a whole.

Socioeconomic Factors Associated with Psychoactive Substance Abuse by Adolescents in Serbia

Adolescence is a period of transition from childhood to adulthood, characterized by efforts to achieve the objectives related to the expectations of the culture, as well as the requirements of the physical, mental, emotional, and social development. It has its own characteristics in the biological, psychological, and social terms, with a process of identity formation, the development of social, and moral norms of behavior (McCabe et al., 2017). Adolescence is a period of great settings in which experimentation with psychoactive substances is common and can, in some cases, lead to the development of long-term addictive behavior (Jeannin et al., 2013). Psychoactive substances include licit, illicit, and prescribed psychoactive medications. Alcohol and cigarette are among the licit and controlled drugs, while marijuana, cocaine, heroin, lysergic diethylamide (LSD), crack, and ecstasy are illicit drugs (Kassa et al., 2014). The use of psychoactive substances in adolescents is often associated with a socioeconomic factors, such as gender, age, type, race, ethnicity, family, and social structures, socioeconomic status of the family (Gebreslassie et al., 2013). Significant risk factors for psychoactive substances use among adolescents were poor parental involvement in the child’s education, conflictual family relationships, and drug abuse by the parents, friends, and neighbors (Kpozehouen et al., 2015; Pisarska et al., 2016). Also, parental alcoholism, parental divorce before age 18, and parental death before age 18 increased the odds of abuse psychoactive substances (Vaughan et al., 2017). Socioeconomic environment in which young people were raised as children predicts their behavior in young adulthood. Understanding this relationship, is an important step in identifying persons at risk (Tobler et al., 2000). In order to identify the risk factors and protective factors associated with psychoactive substances abuse among young people, it is very important tomeasure how socioeconomic factors influence the attitudes and behavior of young toward the use of psychoactive substances (Carter et al., 2010; Patrick et al., 2012).

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%).

Socioeconomic Patterns of Tobacco Use–An Example from the Balkans

Department of Hygiene and Human Ecology, Faculty of Medical Sciences, University of Kragujevac and Institute of Public Health Kragujevac, Kragujevac, Serbia, Center for Informatics and Biostatistics, Institute of Public Health Kragujevac, Kragujevac, Serbia, Department of Social Medicine, Faculty of Medical Sciences, University of Kragujevac, Kragujevac and Institute of Public Health Kragujevac, Kragujevac, Serbia