Current issue
Volume 53, Issue 4, 2025
Online ISSN: 2560-3310
ISSN: 0350-8773
Volume 53 , Issue 4, (2025)
Published: 30.06.2025.
Open Access
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Contents
01.11.2024.
Professional paper
DEMOGRAPHIC AND CLINICAL VARIATIONS IN THE OCCURRENCE OF PEPTIC ULCER - TRENDS OVER A TEN-YEAR PERIOD
Introduction: Peptic ulcer is a chronic recurrent disease of the gastrointestinal tract, which most often occurs as gastric or duodenal ulcer. Peptic ulcer is characterized by certain geographical and temporal trends.
Objective: The aim of this study is to determine the frequency of gastric and duodenal ulcers among subjects who underwent esophagogastroduodenoscopy (EGDS) endoscopy due to dyspeptic complaints, as well as to analyze the trend of ulcer disease over a period of 10 years.
Material and Methods: The data of a total of 4074 subjects with an average age of 54.53 ± 15.03 years, both sexes, 1841 men and 2233 women, who underwent EGDS in 2005 and 2015 calendar years were retrospectively analyzed. Results: This study showed that the trend of ulcer disease significantly decreased in the observed ten-year period, accompanied by concomitant decrease in the prevalence of duodenal ulcers, while the frequency of gastric ulcers retained approximately at the same level. The results showed that men were at greater relative risk than women for the development of duodenal ulcers, in both calendar years. In the ten-year period, the average age of patients with ulcer disease increased by about 4 years, especially in the group with duodenal ulcer, and particularly within women with duodenal ulcer. Compared to 2005, the average age of subjects undergoing EGDS in 2015 increased by about 2 years, regardless of whether or not they were diagnosed with ulcer disease.
Conclusions: In the period 2005 - 2015, the age of patients with peptic ulcer tended to increase, whilst the prevalence of ulcer disease, especially duodenal ulcer, has decreased. The relative risk for duodenal ulcer in men was higher than in women.
Aleksandra Vojinović, Tomica Milosavljević, Biljana Miličić
01.11.2024.
Original scientific paper
SYNCOPA IN CHILDREN AND ADOLESCENTS OUR EXPERIENCE
Introduction: Syncope is a sudden, short-lived, transient loss of consciousness associated with the inability to maintain postural tone. The aim of this paper is: to determine the frequency of syncope in children and adolescents in our conditions, to analyze the characteristics of syncopal episodes and clinical presentation in order to identify the etiology of seizures, and to provide diagnostic protocols, i.e. guidelines for streamlining clinical trials.
Methodology: The diagnosis of the disease was made clinically on the basis of well-taken anamnestic data and a detailed description of the quality of the attack, physical examination and routine laboratory analyzes: (CBC, glycemia, standard ECG). Additional tests were selectively performed: Holter ECG, ergometry, Tilt table test, Echocardiogram, NMR, EEG.
Results: Out of the total number of examined children in the outpatient Children’s Hospital, Department of Pediatric Cardiology, 139 patients (0.6%) reported due to short-term loss of consciousness. The largest number of children was between 15 and 18 years old. Ninety-two ( 66%) of those 139 were girls, and 47 (34%) were boys (p <0.05). Regarding the cause of syncope, it was found in 117 (84%) patients, and in 22 (16%) children the cause of syncope was unknown (p <0.05). Etiologically spreaking, syncope was divided into 3 groups: autonomic (vasovagal, situational, orthostatic, increased vagus tone in athletes) was the most common, in 88 patients (75%), cardiogenic in 5 (4%) and non-cardiogenic in 24 patients.(21%). There was also a recurrence of the attack. In two children, the syncopal attack was repeated 4 times.
CONCLUSION: Syncope most often occurs in teenagers and is mostly benign. To assess syncope, it is necessary to gather a detailed history of the attack, to conduct a detailed physical examination and routine laboratory analyzes: CBC, glycemia and standard ECG. Supplementary diagnostics should be performed exclusively in patients where there is a reasonable suspicion of heart disease or neurological diseases.
Ljiljana Šulović, Danić Filipović, Vladimir Šulović, Zorica Živković, Milica Popović
01.11.2024.
Professional paper
KAWASAKI DISEASE
Kawasaki disease (KD) is an acute, self-limited vasculitis of unknown etiology that occurs predominantly in children under the age of 5 years. In addition to the progress of modern medicine, the cause of KD is currently unknown and specific diagnostic tests for definitive diagnosis does not exist. The differential-diagnostic enigma is the exclusion of other diseases with similar clinical features. The primary treatment in the acute phase of KD is intravenous immunoglobulin (IVIG) and acetylsalicylic acid (ASA/aspirin). There is not a recommendation to a uniform therapeutic approach in refractory KD. The role of corticosteroids is still controversial, but there are studies that support its use as adjuvant treatment. Most patients have a good prognosis. The focus of future research should be the formulation of new algorithms for detection, differential diagnostic triage and treatment of KD.
Slađana Anđelić
15.02.2025.
Original scientific paper
THE PREVALENCE OF ALCOHOL CONSUMPTION AMONG STUDENTS AT THE UNIVERSITY OF BELGRADE
Introduction/Objective
The objective of this study was to determine the prevalence of alcohol use in the student population of the University of
Belgrade.
Methods
The cross-sectional study was conducted in a population of 2,000 students of the Belgrade University. Four faculties (Medicine, Geography,
Economics, Electrical Engineering) from which the students participating in this research were chosen by the method of random choice (by computer
listing), conducted in the period April - June 2010.
Results
Among our respondents, the highest amount of spirits is consumed by respondents from the Faculty of Electrical Engineering, with 22% of
them consuming more than 6 shots on each occasion, while the smallest number of students who drink more than 6 shots on each occasion are from
the Faculty of Economics, with 8%. Students from the Faculty of Electrical Engineering, who have the lowest prevalence of cigarette use, consume
alcohol in a binge drinking pattern. The highest frequency of binge drinking in the past year and in the past month before the survey was among
respondents from the Faculty of Geography.
Conclusion
There is a need for developing a conscience about all the effects that alcohol has, especially physical ones which are not usually noticed
immediately; taking responsibility for own actions; working on a healthy life style and educating people to enhance and improve their health control.
Mirjana Stojanovic-Tasic, Mirjana Virijevic, Kristina Rakic, Emilija Novakovic, Ivana Stasevic Karlicic, Nenad Milosevic, Jelena Aritonovic Pribakovic, Jovana Milosevic, Milica Bogdanovic, Suzana Adzic, Katarina Bisevac, Mary Vuksa
15.02.2025.
Original scientific paper
RECOMMENDATIONS FOR THE APPROACH TO PATIENTS WITH DISORDERS OF THYRIOD GLAND FUNCTION IN THE DENTAL OFFICE
Thyroid hormones, thyroxine and triiodothyronine, affect the work of all organs and organ systems. Whether they are in excess or in deficit, they lead to significant disturbances in the homeostasis of the organism, changing first of all the metabolic processes and leading to significant clinical manifestations, primarily in the cardiovascular, but also in other organ systems. The imbalance of thyroid hormones also has oralmanifestations, which are often the reason why patients visit the dentist. However, what worries dentists the most is the possibility of acute decompensation of hyper or hypothyroidism, with the appearance of thyrotoxic storm or myxedema coma, which are life-threatening conditions. Therefore, a valid pre-procedural evaluation and preparation of patients with thyroid hormone function disorders for pre-planned dental interventions is of great importance. During dental procedures, it is necessary to adhere to recommendations regarding the choice of local anesthetics, hemostasis, drug interactions, the possibility of infection and minimizing stress, all in order to avoid acute decompensation of thyroid imbalance.
Radomir Mitić, Nina Dimitrijević Jovanović, Hristina Ugrinović, Jelena Vulović, Milena Šibalić, Nevena Kalezić
15.02.2025.
Case Reports
IDIOPATHIC PULMONARY HYPERTENSION – CASE PRESENTATION
Pulmonary hypertension (PH) is a hemodynamic condition characterized by a mean pulmonary artery pressure (mPAP) ≥ 25 mmHg at rest, pulmonary arterial wedge pressure (PAWP) ≤ 15 mmHg, and pulmonary vascular resistance (PVR) > 240 dyn·s·cm⁻⁵. The annual incidence of pulmonary arterial hypertension (PAH) is approximately 3–10 new cases per million adults. It is estimated that the prevalence of pulmonary hypertension in individuals over 65 years of age is around 10%.The aim of this study is to present the case of a female patient with progressive dyspnea in whom PAH remained undiagnosed for a prolonged period.A 74-year-old female patient, M.P., was hospitalized in the Coronary Care Unit of the Clinical Center in Kosovska Mitrovica due to symptoms of shortness of breath, choking, fatigue, leg swelling, and weakness. The admission ECG revealed: sinus rhythm, normal axis, high R wave in V2, ST depression, and negative T waves in leads II, III, aVF, and V4–V5. Echocardiography findings showed right ventricular enlargement (2.9 cm), pulmonary artery dilation (3.3 cm), 1–2+ pulmonary regurgitation, and 3+ tricuspid regurgitation, with a systolic pulmonary artery pressure (SPAP) of up to 126 mmHg. The right ventricle measured 5.3 cm in the 4Ch view, with a TAPSE of 1.8 cm. Right heart catheterization revealed the following pressures: PA 78/34/57 mmHg, RV 74/8/10 mmHg, RA 6/6/7 mmHg, CO 4.3 l/min, and LV 99/10/8 mmHg. Although primary pulmonary hypertension is predominantly a disease of younger individuals, it should also be considered in older patients presenting with progressive dyspnea in the absence of structural heart disease.
Kristina Bulatović, Vladan Perić, Maja Šipić, Jovana Milošević, Erdin Mehmedi, Sanja Jovanović
17.02.2025.
Professional paper
INFEKCIJA H. PYLORI KOD PACIJENATA SA DISPEPSIJOM: KLINIČKI, ENDOSKOPSKI I HEMATOLOŠKI NALAZI
Uvod: Dispepsija je čest gastroenterološki sindrom koji značajno narušava kvalitet života. Infekcija bakterijom Helicobacter pylori (H. pylori) ključni
je faktor u razvoju organske dispepsije, dok njena povezanost sa funkcionalnom dispepsijom ostaje predmet istraživanja.
Cilj: Ispitati prevalenciju H. pylori infekcije kod pacijenata sa dispepsijom i njenu povezanost sa simptomima, endoskopskim nalazima i hematološkim
parametrima
Metode: Retrospektivna studija obuhvatila je 117 pacijenata sa dispepsijom pregledanih tokom 2023. godine na Internoj klinici KBC Priština-Gračanica
u Lapljem Selu. Svi su podvrgnuti gornjoj gastrointestinalnoj endoskopiji i testiranju na H. pylori antigen u stolici. Analizirani su demografski podaci,
simptomi, endoskopski i hematološki nalazi.
Rezultati: H. pylori infekcija je potvrđena kod 63,25% pacijenata, bez značajne razlike između polova. Zabeležen je trend porasta prevalencije sa
godinama, ali bez statističke značajnosti (p=0,060). Epigastrični bol (p=0,0068) i gorušica (p<0,0001) su bili značajno češći kod H. pylori pozitivnih
pacijenata, dok su hronični gastritis (p=0,005) i duodenalni ulkus (p=0,029) bili dominantni endoskopski nalazi kod ove grupe. Značajno veći procenat
H. pylori pozitivnih pacijenata imao je snižene vrednosti broja eritrocita i hemoglobina u odnosu na negativnu grupu (p<0,01). Prosečan hematokrit
bio je niži u H. pylori pozitivnoj grupi (p=0,013), ali se nije značajno razlikovao od referentnih vrednosti.
Zaključak: H. pylori infekcija je česta među pacijentima sa dispepsijom i povezana sa specifičnim simptomima, patološkim endoskopskim nalazima i
hematološkim promenama. Testiranje na H. pylori je ključno u proceni dispepsije, dok H. pylori negativni pacijenti sa upornim simptomima zahtevaju
dodatnu dijagnostiku.
Ključne reči: Helicobacter pylori; dispepsija; simptomi; endoskopski nalaz; hematološki parametri
Marko Stalević
17.02.2025.
Professional paper
THE IMPACT OF COVID-19 PANDEMIC ON THE CONSUMPTION OF ANTIDIABETIC DRUGS IN SERBIA: A JOINPOINT TREND ANALYSIS
Background: People with diabetes more often experienced severe clinical forms of COVID-19. However, it has been hypothesized that certain antidiabetic drugs may be associated with better outcomes in COVID-19 patients. The aim of this study was to analyze whether the COVID-19 pandemic influenced the change in consumption of antidiabetic drugs in Serbia.
Methods: This descriptive analysis was carried out using publicly accessible data obtained from the official website of the Medicines and Medical Devices Agency of Serbia during the period 2006-2022. The joinpoint regression analysis was applied to investigate the dynamics of antidiabetic drugs utilization over time.
Results: In the Republic of Serbia, this study analyzed the use of 28 antidiabetic drugs between 2006 and 2022.The results showed that at the beginning of the COVID-19 pandemic, there was an increase in consumption of dulaglutide (starting from 2020) and a decrease in consumption of insulin detemir (starting from 2019), insulin lispro (combined) and insulin lispro (fast-acting) (starting from 2020).
Conclusion: Our study revealed significant changes in the usage of certain antidiabetic drugs, such as increased consumption of dulaglutide and decreased use of various insulin types. These changes reflect the evolving strategies in diabetes treatment to better support patients during this global health crisis.
Key words: antidiabetic drugs, impact of Covid-19, consumption, Serbia
Jelena Filimonovic
17.02.2025.
Professional paper
TRANSPOZICIJA TETIVE EKSTENZOR INDICIS PROPRIJUS ZA EKSENZOR POLICIS LONGUS U CILJU REKONSTRUKCIJE EKSTENZIJE PALCA - PRIKAZ SLUČAJA
Ruptura potkožne tetive ekstenzora policis longusa (EPL) je jedna od najčešćih povreda tetiva ekstenzora šake. Ova vrsta povrede može biti posledica
trauma ručnog zgloba. Češće se javlja kao posledica degenerativne ili inflamatorne bolesti. Ponekad se to dešava bez predisponirajućeg stanja, zbog
kontinuiranih pokreta savijanja i opružanja palca šake.
Ruptura tetive EPL-a se obično dešava u predelu Listerove kvrge gde su trenja najveća. Kontinuirano ponavljanje mikrotrauma može da uzrokuje
rupturu. Engkvist i Lundborg [1] su postavili hipotezu o patogenezi mehanizama ove povrede. Smatrali su da nakon trauma ili zapaljenja formiran
hematom unutar omotača tetive dovodi do povećanja pritiska u neelastičnom prostoru. Povećanje pritiska može izazvati promene u snabdevanju krvi i
može dovesti do nekroze i rupture struktura tetiva. Nakon prekida kontinuiteta tetive EPL-a, retrakcija proksimalnog okrajka je praćena
degenerativnim procesima koji ugrožavaju direktnu suturu.
Predloženi su mnogi tretmani, artrodeza interfalangealnog (IP) zgloba palca ili transpozicija tetive ekstenzor indicis proprius (EIP) koju je razvio
Mensch 1925. god. [1].
Transpozicija tetive šake je hirurška procedura која uključuje repozicioniranje funkcionalne tetive како bi se obnovila funkcija oštećene tetive šake.
Ova operacija ima za cilj da vrati pokret, funkciju i snagu šake.
U ovom radu prenosimo naše iskustvo u lečenja traumatske rupture tetive EPL-a metodom transpozicije tetive EIP-a. Opisujemo operativnu tehniku
transfera tetive EIP-a na tetivu EPL.
Ključne reči: trasnpozicija tetive, ekstenzor policis longus, ekstenzor indicis proprius, funkcija.
Aleksandra Petrović
17.02.2025.
Professional paper
INFORMISANOST, UPOTREBA I STAVOVI STUDENATA MEDICINE O KOGNITIVNIM POJAČIVAČIMA
Uvod: Kognitivni pojačivači (KP) poboljšavaju kognitivne funkcije putem neurotransmitera CNS-a. Čine raznorodnu grupu supstanci koje se
svakodnevno uzimaju kao napici nalik kafi, biljni lekovi i dijetetski suplementi (“meki pojačivači”) ili lekovi koji se koriste u lečenju bolesti
(nootropici). Upotreba i zloupotreba su česte u studentskoj populaciji sa brojnim etičkim pitanjima.
Cilj: Utvrđivanje informisanosti studenata medicine, njihovih stavova o upotrebi i stepenu rizika od neželjenog delovanja KP, na osnovu pretpostavke
da je upotreba ovih supstanci redovna.
Materijal I metode: Studija preseka je sprovedena po tipu anonimnog anketnog istraživanja na Medicinskom fakultetu Priština sa privremenim
sedištem u Kosovskoj Mitrovici. U ispitivanju su dobrovoljno učestvovali studenti medicine prve tri godine integrisanih studija koji nisu položili ispit iz
predmeta Farmakologija sa toksikologijom. Upitnik je obuhvatio socio-demografske podatke, podatke o koncentraciji i navikama u učenju, stepen
informisanosti, procenu upotrebe i procenu rizika korišćenja KP. Stratifikacija uzorka je izvršena prema polu studenata, a Likert-ova skala je poslužila
za rangiranje stavova ispitanika.
Rezultati: Od ukupnog broja anketiranih (n=249) u konačnu statističku analizu podataka uključeno je 169 anketnih upitnika (M 32,5 %, Ž 67,5%).
Najviše studenata je bilo sa druge godine studija (40%), dok je najviše studentkinja bilo sa prve godine (48,2%). Uočena je statistički značajna razlika
između ispitivanih grupa u odnosu na godinu studiranja (p=0,009). Informacije o KP su novina za 40,2% ispitanika (M 49,1%, Ž 36%). Da je o njihovoj
primeni dovoljno informisano smatra 23,7 % ispitanika (M 20%, Ž 25,4%). Postoji statistički značajna razlika u upotrebi internet baza za informisanje o
KP (p<0,001).Najveći broj studenata (71,6%) koristi internet za informisanje o KP, pri čemu je korišćenje internet baza bilo statistički značajno veće
kod žena u odnosu na muškarce (M 56,4 %,Ž 78,9 %; p=0,002). Više od polovine ispitanika (50,3%) koristi Mediately bazu kao pouzdanu bazu podataka o
lekovima. Od ukupnog broja studenata 40,8% upotrebljava neki od navedenih KP (M 43,6%, Ž 39,5%). Najčešći razlozi za upotrebu kod obe grupe
ispitanika su poboljšanje koncentracije (M 27,3%, Ž 28,9%) i uspešnije polaganje ispita (M 25,5%, Ž 15,8%). Oba pola najviše koriste ginko bilobu (M
29,1%, Ž 32,5%) i metilksantine (M 29,1%, Ž 17,5%). Studenti znatno češće upotrebljavaju kreatin u odnosu na studentkinje (M 20%; Ž 2,6%; p=0,003).
Obe grupe studenata su prema medijani i interkvartilnom opsegu (25-75%) uočenog rizika od neželjenih reakcija rangirale kokain (M 9,0; Ž 9,0),
metamfetamin (M 8,0; Ž 8,0) i amfetamin (M 8,0; Ž 7,0) kao najopasnije, dok je ginko biloba procenjena kao najbezbedniji KP (M 3,0; Ž 3,0).
Zaključak: Većina studenata nije dovoljno informisana o kognitivnim pojačivačima, iako ih koriste samoinicijativno, radi postizanja boljih rezultata na
studijama. Neophodno je studente uputiti na adekvatne izvore informisanja i organizovati vannastavne tribine i predavanja o bezbednosti i efikasnosti
KP pre upotrebe. U skladu sa trendovima u svetu, može se očekivati porast zloupotrebe nootropika na univerzitetima i u našoj zemlji. Smatramo da bi
trebalo ponoviti ili organizovati slično ispitivanje kroz par godina, po mogućstvu u većem obimu.
Ključne reči: kognitivni pojačivači, informisanost studenata, stavovi studenata
Aleksa Ilić Keljanović