Burnout syndrome among medical nurse-technicians in intensive care units in cardiovascular surgery.

Background: Healthcare workers in intensive care units work under specifically hard conditions compared to healthcare workers who work under regular clinical conditions. In this sense, the research aims at assessing the level of burnout symptomatology among nurse technicians working in intensive care units for cardiovascular surgery and to compare those burnout levels with those recorded for medical technicians working under regular clinical conditions. Method: The research was designed as a cross-sectional study. The sample consisted of nurse technicians working in intensive care units specializing in cardiovascular surgery (70 participants) and nurse technicians working under regular clinical conditions (70 participants) at the Institute for Cardiovascular Diseases "Dedinje," Belgrade, Serbia. To evaluate the manifestation of burnout syndrome at work, the analysis uses the Serbian version of the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Results: To examine the variances in the average sub-scores for burnout within two groups of medical technicians, the study used Two Independent Samples T-test. The statistically noteworthy differentiation was ascertained for emotional exhaustion and personal accomplishment, but this does not hold true for depersonalization. However, the mean score values across the different burnout levels (low, moderate, high) are similar in two cohorts of respondents (p > 0.05). Conclusion: This study will serve as an impetus for a policy reform focused on ameliorating working conditions and improving healthcare workers' satisfaction and overall healthcare quality.

The Enigma of Mammaglobin: Redefining the Biomarker Paradigm in Breast Carcinoma.

The continuous evolution of cancer biology has led to the discovery of mammaglobin, a potential novel biomarker for breast carcinoma. This review aims to unravel the enigmatic aspects of mammaglobin and elucidate its potential role in redefining the paradigm of breast carcinoma biomarkers. We will thoroughly examine its expression in tumoral and peritumoral tissues and its circulating levels in the blood, thereby providing insights into its possible function in cancer progression and metastasis. Furthermore, the potential application of mammaglobin as a non-invasive diagnostic tool and a target for personalized treatment strategies will be discussed. Given the increasing incidence of breast carcinoma worldwide, the exploration of novel biomarkers such as mammaglobin is crucial in advancing our diagnostic capabilities and treatment modalities, ultimately contributing to improved patient outcomes.

Children's Internet use and physical and psychosocial development.

Introduction: Internet use (IU) commonly refers to sedentary lifestyle and may be addictive, especially among children. The aim of this study was to investigate the relationship between IU and some aspects of child physical and psychosocial development. Methodology: We conducted a cross-sectional survey by using a screen-time based sedentary behavior questionnaire and Strengths and Difficulties Questionnaire (SDQ)-among 836 primary school children in the Branicevo District. The children's medical records were analysed for vision problems and spinal deformities. Their body weight (BW) and height (BH) were measured and body mass index (BMI) was calculated as BW in kilograms divided by BH in meters squared (kg/m2). Results: The average age of respondents was 13.4 (SD 1.2) years. The mean duration of daily Internet use and sedentary behavior was 236 (SD 156) and 422 (SD 184) minutes, respectively. There was no significant correlation between daily IU and vision problems (near sightedness, farsightedness, astigmatism, strabismus), and spinal deformities. However, daily Internet use is significantly associated with obesity (p < 0.001) and sedentary behavior (p = 0.01). There was significant correlation between emotional symptoms with total Internet usage time, and total sedentary score (p < 0.001 for both, r = 0.141 and r = 0.132, respectively). There was a positive correlation between the total sedentary score of children and hyperactivity/inattention (r = 0.167, p < 0.001), emotional symptoms (r = 0.132, p < 0.001), and conduct problems (r = 0.084, p < 0.01). Conclusion: In our study, children's Internet use was associated with obesity, psychological disturbances and social maladjustment.

Social support score in patients with malignant diseases-with sociodemographic and medical characteristics.

Introduction: Social support as a complex construct has a positive influence not only on a patient's condition but also on the process of the patient's emotional adjustment to cancer. The goal of this study is to investigate aspects of the level of social support in oncology patients and its interconnection with sociodemographic and medical variables. Method: The study was conducted as a prospective observational study in 2020, including 250 patients aged 19 and over, both sexes, with a diagnosis of oncological disease. The research was conducted in the Department of General Medicine of the Health Center Trstenik, Central Serbia, after approval by the Ethics Committee of the Health Center Trstenik, Central Serbia. A social support assessment questionnaire (Oslo-3 Social Support Scale) was used as a research instrument. Results: Data collected from the entire study population showed that bad social support was present in almost 90% of cases. Univariate and multivariate regression analysis showed a statistically significant influence of the following variables on the bad social support: education level, activity limitation, difficulties in performing daily activities, the impact of pain on the performance of activities, the need for additional help with activity, the need for help at home, unfulfilled needs for health care, means of information, anxiety score and depression score. Conclusion: Interventions to increase social support may be important for enhancing mental health and quality of life in cancer patients.

Secondary Breast Malignancy from Renal Cell Carcinoma: Challenges in Diagnosis and Treatment-Case Report.

Renal cell carcinoma represents about 2% of all malignant tumours in adults. Metastases of the primary tumour in the breast make up to about 0.5-2% of the cases. Renal cell carcinoma metastases in the breast are extremely rare and have been sporadically recorded in the literature. In this paper, we present the case of a patient with breast metastasis of renal cell carcinoma 11 years after primary treatment. Case presentation: An 82-year-old female who had right nephrectomy due to renal cancer in 2010 felt a lump in her right breast in August 2021, whereby a clinical examination revealed a tumour at the junction of the upper quadrants of her right breast, about 2 cm, movable toward the base, vaguely limited, and with a rough surface. The axillae were without palpable lymph nodes. Mammography showed a circular and relatively clearly contoured lesion in the right breast. Ultrasound showed an oval lobulated lesion of 19 × 18 mm at the upper quadrants, with strong vascularisation and without posterior acoustic phenomena. A core needle biopsy was performed, and the histopathological findings and obtained immunophenotype indicated a metastatic clear cell carcinoma of renal origin. A metastasectomy was performed. Histopathologically, the tumour was without desmoplastic stroma, comprising predominantly solid-type alveolar arrangements of large moderately polymorphic cells, bright and abundant cytoplasm, and round vesicular cores with focally prominent nuclei. Immunohistochemically, tumour cells were diffusely positive for CD10, EMA, and vimentin, and negative for CK7, TTF-1, renal cell antigen, and E-cadherin. With a normal postoperative course, the patient was discharged on the third postoperative day. After 17 months, there were no new signs of the underlying disease spreading at regular follow-ups. Conclusion: Metastatic involvement of the breast is relatively rare and should be suspected in patients with a prior history of other cancers. Core needle biopsy and pathohistological analysis are required for the diagnosis of breast tumours.

Antimicrobial Treatment of Serratia marcescens Invasive Infections: Systematic Review.

Background: Serratia marcescens (SM) is a Gram-negative pathogen discovered by Italian pharmacist, Bizio, in 1819. According to the literature, S. marcescens is resistant to a wide range of antibiotics, including penicillin, cephalosporin, tetracycline, macrolide, nitrofurantoin, and colistin. We conducted a systematic review of published reports, determined what invasive infections could cause SM, and established the most appropriate antibiotic therapy. Methods: We registered this systematic review on the PROSPERO registry of systematic reviews-meta-analyses before we started our research (registration number CRD42022323159). The online searches of published studies were implemented via MEDLINE, the Cochrane Central Register of Controlled Trials, EBSCO, Scopus, Google Scholar, SCIndex, and the registry of clinical studies of human participants (ClinicalTrials.gov). Results: Our study included 32 published articles (9 case series and 23 case reports). There were 57 individual cases, respectively. The oldest patient was 97 years and the youngest patient was a newborn. S. marcescens was, in most cases, isolated from blood followed by urine and cerebrospinal fluid. In most cases, sensitivity was tested to cotrimoxazole (from 27 isolates, 10 showed resistance) followed by gentamicin (from 26 isolates, 3 showed resistance) as well as amikacin (from 21 isolates, none showed resistance). Patients died from an infection in 21 cases (31%). Conclusions: Treatment of SM infections should include carbapenems or aminoglycosides in combination with third-generation (and eventually fourth-generation) cephalosporin. Cotrimoxazole should be considered in cases of uncomplicated urinary infections.

The impact of the COVID-19 pandemic on the trend of prescribing long-acting injections of paliperidone and risperidone in Central Serbia.

Since the end of 2019, the global spread of COVID-19 has represented a historic event that changed our way of treating patients globally. The use of long-acting injections (LAI) antipsychotics was emphasized. Our goal was to investigate the impact of COVID-19 on the frequency of prescribing LAI and compare it with a period before. All patients (198) who started LAI-risperidone or LAI-paliperidone for the period 2017-2022, in Kragujevac, the city in Central Serbia, were considered. The frequency of prescribing LAI before and during COVID-19 and the total number of prescribed LAI per year were compared. Separately, the frequency of prescribing LAI-R and the frequency of prescribing LAI-P were compared. The significant (p < 0,05) increase in the use of LAI risperidone and paliperidone was in 2020 and 2021 [per year 2017(3), 2018(6), 2019(26), 2020(75), 2021(55), and 2022(33)]. The significant (p < 0,05) increase in monthly and quarterly preparations of LAI paliperidone was in 2020 and 2021 relative to the years before the pandemic. As the pandemic weakened, the inclusion of LAI paliperidone therapy weakened during 2022. A significant increase in usage of LAI risperidone was in 2022, and in 2020 and 2021 was as it was in the period 2017-2019. During COVID-19, especially in years when COVID-19 restriction measures were stricter, there was a significant change in the application method of antipsychotic therapy in favor of LAI. Regardless of the increase in treatment costs, patients' interests and protection were prioritized in the treatment process.

Attitudes of Primary School Teachers Toward Inclusive Education.

Background: The aims of our study are related to examining the relevance of teachers' attitudes toward the implementation of inclusive education. In addition, its subject is related to the implications on inclusive education policies, limitations of the existing study along with the recommendations for our future research endeavors. Methods: The research is a cross-sectional study type. The sample included 64 primary school teachers in the lower grades of primary school (grades 1-4), selected by using simple random sampling, in three primary schools on the territory of Belgrade, Serbia in 2021 (26, 17, and 21 primary school teachers). The Questionnaire for Teachers, which was used as a research instrument, was taken from the Master's Thesis Studen Rajke, which was part of the project "Education for the Knowledge Society" at the Institute for Educational Research in Belgrade. Dependent variables measured in the study referred to the attitudes of primary school teachers toward inclusive education. Categorical variables are represented as frequencies and the Chi-square test was used to determine if a distribution of observed frequencies differed from the expected frequencies. Results: One in three teachers (32.8%) thought that inclusion was useful for children with disabilities (29.7%), of them thought that schools did not have the conditions for inclusive education, whereas one in four teachers (25.0%) believed that inclusion was not good. No statistically significant differences were found in the attitudes of professors, when observed in terms of their gender, age and length of service. Conclusion: Investing more resources and time in developing and implementing special education policies can promote successful inclusive education.

Lifestyle, Physical Activity, Eating and Hygiene Habits: A Comparative Analysis Before and During the COVID-19 Pandemic in Student Population.

Background: Changing daily habits such as diet, hygiene and physical activity may be some of the consequences of the COVID-19 pandemic. The aim of the study was to analyze the effect of this pandemic on lifestyle, physical activity, eating and hygiene habits among students. Methods: This cross-sectional study involved 171 students from the Faculty of Medical Sciences, University of Kragujevac, Serbia. Data were statistically analyzed using Wilcoxon Signed-Rank test, Marginal homogeneity test and Chi-square test. The differences were considered statistically significant when p ≤ 0.05. Results: In this study, it was observed that the most common physical activity before the pandemic was walking, while during the pandemic was home exercising. Compared to the period before the pandemic, there was no difference in the time spent engaging in daily physical activity (p = 0.334). However, there was a significant increase in sitting time during the pandemic (p = 0.005). Difference was noticed in the use of breakfast, the number of meals, and the type of fat in the diet before and during the pandemic (p = 0.000). During the pandemic, there was an increase in the use of fruits (p = 0.000), vegetables, and nuts (p = 0.001), while the use of fast food and alcohol have decreased. During the COVID-19 pandemic, a significant increase in the use of dietary supplements was observed (40.2%), (p = 0.008). Conclusions: Given that the COVID-19 pandemic is ongoing, certain changes in lifestyle observed in this study should be confirmed in more extensive population studies.

Barriers Affecting the Oral Health of People Diagnosed with Depression: A Systematic Review.

INTRODUCTION: The problems of oral health of people diagnosed with depression are not adequately recognized, either in developed or developing countries. Social stigma, lack of self-interest, or even inadequate approaches of dental doctors towards the unique situation of this group of people this lead to excessive oral health problems. METHODS: The bibliographic database PubMed/Medline, Google Scholar, and Whiley online library were searched using the following text and MeSH as separate key terms and in combination: depression and oral health/dental caries/periodontal disease/tooth loss/utilization of oral health services/and barriers. The content of documents was analysed using qualitative methodology. RESULTS: Twenty-six original studies were included in the review. Level/severity of depression, medication and medical comorbidity are the most important medical barriers influencing the oral health of people diagnosed with depression. Dental fear and anxiety are mostly combined with low oral hygiene and bad oral health. Socioeconomic status, dental insurance, bad habits and education also have important roles in the oral health status of people diagnosed with depression. CONCLUSION: Including individuals with depression and oral health problems in national health programs, creating specific prevention programs, or subsidizing the cost of treatment are some of the recommendations suggested as solutions.

Analysis of Mortality from Carcinomas Primary Localized in Region of Lip, Oral Cavity and Pharynx in Central Serbia, 1999-2015.

BACKGROUND: Lip, oral cavity, and pharyngeal cancers have been globally estimated to account for about 3.8% of all cancer cases and 3.6% of cancer deaths. Mortality of these cancers is generally higher in developing than in developed countries. Overall cancer mortality rate in Serbia is one of the highest in the world. The aim of this study was to determine the mortality rate trends and the most common localization of lip, oral and pharyngeal cancers in Serbia. METHODS: The study was conducted in 2018 as descriptive epidemiological study and included years from 1999 to 2015. The differences in standardized mortality rates and number of deaths were analyzed with regard to age, gender, and tumor localization. Linear trend and regression were used to determine mortality rate trend. RESULTS: There was statistically significant difference in the number of deaths between men and women in the ages of 40 and over (P < 0.01); male/female cancer mortality ratio was 4.56:1. Generally, the most common localization of this carcinoma was hypopharynx. There was no statistically significant increase of mortality rates from these cancers for both genders (males: y = 4.77 + 0.42x, P = 0.069 % change = +20.35; females: y = 1.03 + 0.01x, P = 0.40 % change = +4) during 17-year period. CONCLUSION: Promotion of healthy habits, life-styles and regular inspection of mouth by patients and health professionals should be better prioritized especially in developing countries where implementing and improving national health prevention programs are essential.