Importance of Demographic and Clinical Features in Evaluating the Severity of COVID-19 in Hospitalized Patients: A Serbian Retrospective Study in the First Pandemic Year.

The aim of this study is to determine the demographic and initial clinical characteristics of patients with COVID-19 and their importance in evaluating the severity of the disease. A retrospective study included patients suffering from COVID-19 who were hospitalized at The Department of Infectious Disease of the Clinical Hospital Center Pristina-Gracanica from the beginning of the pandemic until the end of 2020. We compared the symptoms of the disease, radiographic findings of pneumonia, laboratory parameters, duration of symptoms before admission, the difference in the need for certain therapies, and the presence of comorbidities between non-severe and severe groups of patients. Patients with a severe disease were statistically significantly older. Hypertension was significantly associated with severe clinical conditions. Radiographic findings of bilateral pneumonia on admission were much more frequent among the severe group, and these patients' need for oxygen support was significantly higher. Lower neutrophil and higher lymphocyte counts were statistically significant in the non-severe group. Biochemical parameters at admission also showed statistical significance between the examined groups. Based on our research, we can conclude that a complete overview of the patient, including demographic and laboratory parameters as perhaps the most significant attributes, can help doctors in the timely clinical assessment of patients and, thus, in the timely application of adequate therapeutic protocols in the treatment of COVID-19.

The measles epidemic in northern Kosovo and Metohija, Serbia, October 2017-August 2019.

INTRODUCTION: Measles is among the most contagious and vaccine-preventable respiratory diseases. The aim of this research was to describe the socio-demographic profile, clinical manifestations and laboratory parameters of measles patients hospitalized at Kosovska Mitrovica Clinical Centre during the 2017-2019 outbreak. METHODOLOGY: The prospective study included all patients that had contracted measles (107) who were hospitalized at Kosovska Mitrovica Clinical Centre during the outbreak. All complications that led to hospitalization were analyzed and the frequencies of complications with respect to patient age and vaccination status were recorded. RESULTS: More than half (51%) of the patients were unvaccinated. Patients' age varied statistically significantly with respect to vaccination status. Pneumonia was noted in 65% of the patients from the younger age group, compared to 32% of adults, and this difference was statistically significant. Hepatitis was a significantly more frequent complication in adults, affecting 36% of measles patients in this age group, compared to only 7% of those aged below 18 years. In the unvaccinated group, 71% pneumonia frequency was noted, compared to 11% and 35% in the vaccinated and unknown vaccination status groups, respectively. The differences in frequencies based on vaccination status were statistically significant. CONCLUSIONS: Most hospitalized patients were unvaccinated. Complications showed a significant difference with respect to the age and vaccination status of patients. Therefore, it is necessary to carry out continuous health promotion activities to raise awareness among the entire population of the importance and need for vaccination of children against measles, but also adults who have not been previously vaccinated.

The burden and health care use of patients with migraine and tension-type headache in post-conflict area of Serbia.

PURPOSE: The aim of the present study was to assess the burden and health care use of adult patients with migraine and tension type headache in a post-conflict area of Serbia. METHODS: This cross-sectional study was conducted on a representative sample of adults, living in predominantly Serb communities on the Kosovo and Metohija territory. The required data was obtained through a survey, utilizing a culturally-adapted questionnaire. The study sample comprised of 1,062 adults. RESULTS: In the year preceding the study, 49.7% of included subjects suffering from migraines and 27.5% of those experiencing tension type headache sought medical assistance for their condition. The majority (88.5%) of the respondents utilized non steroid antiinfammatory drugs as analgesic, while 14.2% used prophylactic treatment. Migraine sufferers reported losing on average 11.1 days in a 3-month period, while those experiencing tension type headache lost 4.7 days (p < 0.001) due to headaches, preventing them from partaking in professional, family and social activities. On headache-free days, 24.5% of the respondents were anxious or tense in anticipation of a headache onset, while 30% did not feel that the headache had completely resolved. Moreover, 11.5% of the sample reported never or rarely feeling in control of the headache, while 20% of the respondents were of view that their headaches were not taken seriously by their employer and co-workers and rarely discuss them. Adverse effect of headaches on education is more frequently noted by migraine sufferers than those experiencing tension type headache (p = 0.001), and this disparity persists in relation to career (p < 0.001) and family planning (p = 0.001). CONCLUSIONS: In Kosovo and Metohija, primary headaches exert a profound influence on the affected individuals and their community, and thus require recognition as one of the priorities of social initiatives aimed at the enhancement of public health.

Serological status of childbearing-aged women for Toxoplasma gondii and cytomegalovirus in northern Kosovo and Metohija.

INTRODUCTION: Toxoplasma gondii and cytomegalovirus (CMV) are pathogens associated with congenital anomalies. METHODS: Serum was collected from 79 reproductive-age women and tested for IgM and IgG antibodies to T. gondii and CMV. RESULTS: Seropositivity for T. gondii was detected in 24.1% of women and CMV in 96.2%. High seropositivity for CMV was found for all ages. The highest seropositivity for T. gondii was observed among older participants. CONCLUSIONS: T. gondii remains an important pathogen owing to low seropositivity.

Serological status of childbearing-aged women for Toxoplasma gondii and cytomegalovirus in northern Kosovo and Metohija

Abstract INTRODUCTION: Toxoplasma gondii and cytomegalovirus (CMV) are pathogens associated with congenital anomalies. METHODS: Serum was collected from 79 reproductive-age women and tested for IgM and IgG antibodies to T. gondii and CMV. RESULTS: Seropositivity for T. gondii was detected in 24.1% of women and CMV in 96.2%. High seropositivity for CMV was found for all ages. The highest seropositivity for T. gondii was observed among older participants. CONCLUSIONS: T. gondii remains an important pathogen owing to low seropositivity.

Is Balint training associated with the reduced burnout among primary health care doctors?

The aim of our study was to examine whether the participation in Balint group is associated with the reducing burnout syndrome among primary health care doctors. This investigation was conducted on a population of 210 doctors employed in primary health centers in Belgrade. Out of 210 doctors, 70 have completed Balint training for a period of at least 1 year, whereas 140 doctors have never attended this training (the Non-Balint group). The level of burnout among physicians was assessed with the Serbian translation of the original 22-item version of the Maslach Burnout Inventory - Human Services Survey which defines burnout in relation to emotional exhaustion, depersonalization and personal accomplishment. We found that 45.0% of the Non-Balint participants and 7.1% of the Balint-trained participants responded with symptoms of high level of emotional exhaustion, with a statistically significant difference (p < 0.001). In relation to depersonalization, 20% of the Non-Balint subjects were highly depersonalized compared to 4.4% of the Balint-trained subjects, with a statistically significant difference (p < 0.001). Regarding the personal accomplishment, 21.4% of the Non-Balint subjects and 7.1% of the Balint-trained subjects had a perception of low personal accomplishment, with a statistical significance (p < 0.001). In the multiple ordinal logistic model, with emotional exhaustion as a dependent variable, statistically significant predictor was female gender (OR = 2.51; p = 0.021), while Balint training was obtained as a protective factor (OR = 0.12; p < 0.001). Non-specialists were detected as a risk factor for depersonalization (OR = 2.14; p = 0.026) while Balint group was found as a protective factor (OR = 0.10; p < 0.001), according to the multiple ordinal logistic regression analysis. Regarding the reduced personal accomplishment, our results indicated that nonspecialists were at risk for this subdimension (OR = 2.09; p = 0.025), whereas Balint participants were protected (OR = 0.18; p < 0.001). Participation in Balint groups is associated with the reduced burnout syndrome among primary health care doctors.

Influence of Family Smoking Habits and Passive Smoking on Smoking Status Among Belgrade University Students.

BACKGROUND: There are many factors that affect smoking behavior. OBJECTIVE: The aim of our study was to identify the most important risk factors related to smoking in the sample population of students at the University of Belgrade with a special emphasize on the family role. METHODS: The cross-sectional study was conducted in a population of 2,000 students of the Belgrade University. Four faculties (Medicine, Geography, Economics, and Electrical Engineering) from which the students participating in this research were chosen by the method of random choice, conducted in the period April-June 2010. RESULTS: Independent risk factors for smoking in students, assessed by multivariate logistic regression analysis, included: repeating a year (odds ratio (OR) = 1.67, p < .001), the number of hours spent in the rooms where others smoke (OR = 2.86, p < .001), brother smoker (OR = 1.88, p < .001), sister smoker (OR = 2.33, p < .001), knowledge about the association between smoking and lung cancer (OR = 0.31, p < .001), and depression (OR = 1.02, p = .013). CONCLUSION: Bearing in mind the influence of siblings, prevention, and intervention efforts should be focused more on family members than on the broader social environment. The results also indicate the need to develop a conscience on a healthy life style and to educate people to enhance and improve their health control.

CONTEMPORARY PRINCIPLES OF SUICIDE PREVENTION.

INTRODUCTION: Suicide remains a significant public health problem worldwide. This study is aimed at analyzing and presenting contemporary methods in suicide prevention in the world as well as at identifying specific risk groups and risk factors in order to explain their importance. in suicide prevention. MATERIAL AND METHODS: The literature search covered electronic databases PubMed, Web of Science and Scopus. In order to select the relevant articles, the authors searched for the combination of key-words which included the following medical subject heading terms (suicide or suicide ideation or attempted) and (prevention or risk factors) and (man or elders or mental disorders). Data analysis covered meta-analyses, systematic reviews and original scientific papers with different characteristics of suicide preventions, risk factors and risk groups. RESULTS: Worldwide evidence-based interventions for suicide prevention are divided in universal, selective and indicated interventions. Restricted approach to various methods of committing suicide as well as pharmacotherapy contributes to a lower suicide rate. Suicide risk factors can be categorized as proximal and distal. The following groups are at highest risk of committing suicide: males. older persons and persons with registered psychiatric disorders. CONCLUSION: There is a lot of evidence that suicide is preventable. It is known that only 28 coun tries in the world have national suicide prevention strategies and Serbia is not one of them.

Association between somatic diseases and symptoms of depression and anxiety among Belgrade University students.

AIM: To investigate the relationship between somatic health problems and comorbid condition of anxiety and depression. METHODS: The cross-sectional study in a population of 2,000 students of the Belgrade University (four schools: Medicine, Geography, Economics, Electrical Engineering) during the period April - June 2010 was conducted. The students were randomly selected. The main instrument for data collection was a standardized epidemiological questionnaire, designed at the Institute of Epidemiology, School of Medicine in Belgrade. RESULTS: According to the Hamilton Depression Scale (HAMD), correlation was found between the following somatic diseases and depression: diabetes (p=0.003), hypertension (p=0.007), heart disease (p=0.001), chronic bronchitis (p=0.033), neurological diseases (p=0.013), and gastric or duodenal ulcer (p=0.003). According to the Hamilton Anxiety Scale (HAMA) a correlation was found between the following somatic diseases and anxiety: diabetes (p=0.020), hypertension (p less than 0.001), heart disease (p=0.000), chronic bronchitis (p=0.037), bronchial asthma (p=0.049), gastric or duodenal ulcer (p=0.003). CONCLUSION: Depression and anxiety are common in persons with somatic diseases and have a significant association with physical health. This has considerable implications for somatic diseases management and clinical guidelines.

Radionuclides and heavy metals in Borovac, Southern Serbia.

BACKGROUND, AIM, AND SCOPE: The paper presents the complex approach to the assessment of the state of the environment in Southern Serbia, surroundings of Bujanovac, the region which is of great concern as being exposed to contamination by depleted uranium (DU) ammunition during the North Atlantic Treaty Organization (NATO) attacks in 1999. It includes studies on concentrations of radionuclides and heavy metals in different environmental samples 5 years after the military actions. MATERIALS AND METHODS: In October 2004, samples of soil, grass, lichen, moss, honey, and water were collected at two sites, in the immediate vicinity of the targeted area and 5 km away from it. Radionuclide ((7)Be, (40)K, (137)Cs, (210)Pb, (226)Ra, (232)Th, (235)U, (238)U) activities in solid samples were determined by standard gamma spectrometry and total alpha and beta activity in water was determined by proportional alpha-beta counting. Concentrations of 35 elements were determined in the samples of soil, moss, grass, and lichen by instrumental neutron activation analysis (INAA). RESULTS: The results are discussed in the context of a possible contamination by DU that reached the environment during the attacks as well as in the context of an environmental pollution by radionuclides and heavy metals in Southern Serbia. The results are compared to the state of environment in the region and other parts of the country both prior to and following the attacks. DISCUSSION: This is the first comprehensive study of the contents of radionuclides and heavy metals in Southern Serbia and consequently highly important for the assessment of the state of environment in this part of the country concerning possible effects of DU ammunition on the environment, as well as anthropogenic source of pollution by radionuclides and heavy metals and other elements. Also, the highly sensitive method of INAA was used for the first time to analyze the environmental samples from this area. CONCLUSIONS: The results of the study of radionuclides in the samples of soils, leaves, grass, moss, lichen, honey, and water in Southern Serbia (Bujanovac) gave no evidence of the DU contamination of the environment 5 years after the military actions in 1999. Activities of radionuclides in soils were within the range of the values obtained in the other parts of the country and within the global average. The ratio of uranium isotopes confirmed the natural origin of uranium. In general, concentrations of heavy metals in the samples of soils, plant leaves, mosses, and lichen are found to be less or in the lower range of values found in other parts of the country, in spite of the differences in plant and moss species or soil characteristics. Possible sources of heavy metal contamination were identified as a power coal plant in the vicinity of the sampling sites and wood and waste burning processes. RECOMMENDATIONS AND PERSPECTIVES: The collected data should provide a base for the health risk assessments on animals and humans in the near future. It should be emphasized that the sampling was carried out 5 years after the military action and that the number of samples was limited; therefore, the conclusions should be accepted only as observed tendencies and a detailed study should be recommended in the future.

First assessment of the PM10 and PM2.5 particulate level in the ambient air of Belgrade city.

INTENTION, GOAL, SCOPE, BACKGROUND: As the strong negative health effect of exposure to the inhalable particulate matter PM10 in the urban environment has been confirmed, the study of the mass concentrations, physico-chemical characteristics, sources, as well as spatial and temporal variation of atmospheric aerosol particles becomes very important. OBJECTIVE: This work is a pilot study to assess the concentration level of ambient suspended particulate matter, with an aerodynamic diameter of less than 10 microm, in the Belgrade central urban area. Average daily concentrations of PM10 and PM2.5 have been measured at three representative points in the city between June 2002 and December 2002. The influence of meteorological parameters on PM10 and PM2.5 concentrations was analyzed, and possible pollution sources were identified. METHODS: Suspended particles were collected on Pure Teflon filters by using a Mini-Vol low-volume air sampler (Airmetrics Co., Inc.; 5 l min(-1) flow rate). Particle mass was determined gravimetrically after 48 h of conditioning in a desiccator, in a Class 100 clean room at the temperature T = 20 degrees C and at about 50% constant relative humidity (RH). RESULTS AND DISCUSSION: Analysis of the PM10 data indicated a marked difference between season without heating--(summer; mean value 56 microg m(-3)) and heating season--(winter; mean value 96 microg m3); 62% of samples exceeded the level of 50 microg m(-3). The impact of meteorological factors on PM concentrations was not immediately apparent, but there was a significant negative correlation with the wind speed. CONCLUSIONS: The PM10 and PM2.5 mass concentrations in the Belgrade urban area had high average values (77 microg m(-3) and 61 microg m(-3)) in comparison with other European cities. The main sources of particulate matter were traffic emission, road dust resuspension, and individual heating emissions. When the air masses are coming from the SW direction, the contribution from the Obrenovac power plants is evident. During days of exceptionally severe pollution, in both summer and winter periods, high production of secondary aerosols occurred, as can be seen from an increase in PM2.5 in respect to PM10 mass concentration. RECOMMENDATION AND OUTLOOK: The results obtained gave us the first impression of the concentration level of particulate matter, with an aerodynamic diameter of less than 10 microm, in the Belgrade ambient air. Due to measured high PM mass concentrations, it is obvious that it would be very difficult to meet the EU standards (EEC 1999) by 2010. It is necessary to continue with PM10 and PM2.5 sampling; and after comprehensive analysis which includes the results of chemical and physical characterization of particles, we will be able to recommend effective control measures in order to improve air quality in Belgrade.