Background/Aim. Along with the great impact of 2019 coronavirus disease (COVID-19) on physical health, social functioning, and economy, this public health emergency have significant impact on mental health of people as well. Assessment of the impact of outbreak-related information and public trust in the health system and preventive measures during the COVID-19 outbreak in Serbia in 2020 on levels of anxiety and depression in education, army and healthcare professionals. Methods. An anonymous questionnaire was disseminated to skilled professionals working in fields of education, army, and healthcare. The questionnaire included Beck Anxiety Inventory, Zung Self-Rating Depression Scale, as well as the section assessing the perceived disturbance by the outbreak-related information and the trust of participants in healthcare system and preventive measures proposed by the crisis team. Results. Out of 110 subjects enrolled in this study (mean age 35.25?9.23 years), 59.1% were women. Among healthcare workers, the frequency of perceiving outbreak-related information available on public media as disturbing, as well as the average level of anxiety, were higher compared to the group of army professionals (p<0.05). Women also perceived outbreak-related information available on public media as disturbing in a higher percentage compared to men (p<0.01), and had higher levels of anxiety (p=0.01) and depression (p<0.05). The lack of public trust was associated with higher levels of depression, and the perception of outbreak-related information as disturbing with higher levels of both anxiety and depression. Conclusion. Significant perception of outbreak-related information as disturbing among healthcare workers, as well as the lack of trust in healthcare system and preventive measures proposed by the crisis team are important factors influencing the mental state. This finding has the guiding purpose for competent institutions to make efforts to increase public trust, as one of the important preventive measures, in order to preserve and improve the mental well-being of the population in epidemiological situations.
Uvod. Glavobolje se definišu kao bol lokalizovan iznad orbitomeatalne linije. Dijagnostikuju se i leče nedovoljno. Cilj rada. Ispitati koliko lekari u opštoj medicini znaju o dijagnostičkom i terapijskom pristupu glavoboljama i da li postoji razlika u odnosu na pol i region gde rade. Metod. Na našem godišnjem skupu, Dani opšte medicine, održanom 30.03.2019. godine u Beogradu, realizovana je akreditovana provera znanja na temu Pristup pacijentu sa glavoboljom u opštoj medicini. Test koji je sadržao 50 pitanja o rešavanju kliničkih problema kod različitih tipova glavobolja, položen je sa >60% tačnih odgovora. Podaci su obrađeni softverskim statističkim paketom SPSS 20. Statistička značajnost je definisana za nivo p<0,05. Rezultati. Test je popunilo 432 lekara, sa 98,4% tačnih odgovora. Primenom stratifikovane terapije, migrenu leči 29,5% (p=0,746). Antiemetike ordinira 7,2% lekara. Indometacin kao dijagnostičko-terapijski test poznaje 38,4%. Kortikosteroidnu terapiju kod arteritisa džinovskih ćelija pravilno primenjuje 57,7%. Glavobolje uzrokovane vaskularnim poremećajima imaju 56,9% tačnih odgovora. Njih 31,7% ispravno sumnja na disekciju unutrašnje karotidne arterije (p=0,631). Intrakranijalnu neoplazmu 40% lekara dijagnostikuje magnetnom rezonancijom. Ispravan pristup kod hipertenzivne krize ima 87,2%. Bakterijski meningitis uspešno prepoznaje 83,3% ispitanika. Dijagnostiku i terapiju glavobolja koje se pripisuju supstancijama ili njihovoj obustavi, prepoznaje 74,2%, a prekomernoj upotrebi medikamenata 51,9%. U odgovorima nema značajne razlike u odnosu na pol, ali su lekari iz uže Srbije dali više tačnih odgovora (p=0,005). Zaključak. Lekari su pokazali visok nivo znanja o dijagnostičkom i terapijskom pristupu glavoboljama. Nedostaju znanja o glavoboljama uzrokovanim kranijalnim ili cervikalnim vaskularnim događajima. Ključne reči: Glavobolja, dijagnostika, terapija, primarna zdravstvena zaštita. Zahvalnost Izražavamo posebnu zahvalnost prof. dr Svetlani Simić na učešću u izradi akreditovanog testa, koji je poslužio kao instrument ovog istraživanja. Takođe, zahvaljujemo prim. dr Slavoljubu Živanoviću, prim. dr Dragici Kosi, prim. dr Mirjani Pešić i prim. dr Vesni Marić, koji su popunjene testove unosili u elektronsku bazu podataka.
Pharmacy institutions are one of the key elements in modern healthcare systems throughout the world. Pharmacies can be a part of the public healthcare system at primary, or secondary and tertiary levels. Also, pharmacies can be founded as a private institution, having the same roles and amount of responsibility compared to public ones. The aim of this paper was to examine the role of pharmacies in emergency and catastrophic events. The crucial role of pharmacies is especially emphasized in emergency and catastrophic events when the majority of other healthcare institutions are mobilized in providing more important healthcare activities and services. In those instances, pharmacies represent a primary connection between the patients and community in general and the healthcare system. Proper fulfillment of necessary requirements for registration of pharmacy institutions is essential for its successful operation, but continuous education of pharmacy staff plays an equally important role. The most recent events, such as the COVID-19 pandemic, are one additional evidence confirming that pharmacy institutions are an irreplaceable link in the healthcare system chain continuously serving as a first-line connection with all individuals in a community.
INTRODUCTION: The World Health Organization defines patient adherence as the willingness to adapt its behavior (in terms of therapy, diet, lifestyle, and diagnostic procedures) to the recommendations agreed with the healthcare provider. Objective. The study aimed to determine the impact of socio-demographic factors and length of elevated blood pressure on the adherence of patients with arterial hypertension. METHOD: The study was performed as a cross-sectional study. The sample consisted of 170 patients, 88 (51.8%) women and 82 (48.2%) men, with a mean age of 58 ± 7.9 years. In addition to the general questionnaire, the study used the Adherence in Chronic Diseases Scale. RESULTS: Statistically significantly higher adherence was found in subjects aged 60-69 years and participants in the study with arterial hypertension for more than 15 years (p<0.05). Subjects with completed primary school had statistically significantly lower adherence (p<0.05). Place of residence, employment status and gender of the respondents did not show a statistically significant influence on the adherence of the respondents (NS). CONCLUSION: It uses the age, educational status and duration of arterial hypertension in the adherence of examination statistics. Place of residence, employee status and gender of respondents do not show a statistically significant impact.
The concept of quaternary prevention was integrated in 1999. into the international WONCA vocabulary as actions taken to identify patients at risk of overprescribing drugs and diagnostic procedures that would do them more harm than good. The aim was to determine the place and role of quaternary prevention in primary care. The papers published until 31.12.2022. have been analyzed. We searched Medline, PubMed, Cochrane Library, Scopus, Google Scholar, Science Direct, Mendeley, Serbian medical journals, books, strategies, and doctoral theses. The terms we used were: quaternary prevention, general medicine, overmedication, and diagnostic procedures. We restricted ourselves to works written in Serbian, English, and Croatian. Search has been performed from 01.09.2022. to 31.12.2022. Preferred Reporting Items for Systematic Review (PRISMA) scale parts were used to determine the validity of the papers collected. A total of 1899 papers were identified. We did not find meta-analyses, systematic literature reviews, and randomized studies. A total of 194 were analyzed. Highlighted as relevant 36. Quaternary prevention in primary care refers to the overuse of radiological and laboratory examinations, antibiotics, screening, individual patient access, good communication, reliance on evidence-based medicine, the workload in teams of selected doctors, and prompt consent to patient requests. Some sick patients are undiagnosed, concerned about their health, with functional problems, psychosomatic disorders, and unusual behavior during illness. Quaternary prevention has a place in breast and prostate cancer screening, immunization, mental health and osteoporosis drug marketing, hypertension, prediabetes, and dyslipidemia, a private health insurance program, and the use of high-resolution diagnostic technology. The most powerful way to avoid unnecessary medical procedures is to consistently apply evidence-based medicine.
The prevalence of obesity is growing rapidly in all regions of the world. This is of great importance for public health because morbidity associated with obesity and its complications reduces life expectancy and imposes unsustainable economic burdens on both society and health services. Reduced physical activity and unhealthy eating habits have led to an increase in obesity among young people in many countries which poses a significant health risk. Obesity significantly increases the risk of developing noncommunicable diseases. Type 2 diabetes is increasingly being diagnosed in obese children and adolescents, and being overweight in childhood is associated with poor cardiovascular outcomes and increased adult mortality. Monitoring changes in the prevalence of obesity and its future impact on chronic diseases and life expectancy is essential to understanding the challenges and potential benefits of interventions.
Liposarkom je redak maligni tumor porekla masnog tkiva, sa incidencom manjom od 1/1000000. Razlikujemo tri tipa tumora masnog tkiva: benigne (lipome), intermedijalne (dobro diferentovane liposarkome) i maligne (dediferentovane, miksoidne, pleomorfne i neklasifikovane liposarkome). Dediferentovan liposarkom je kombinacija masnih i sarkomskih ćelija. Sporo raste i rana dijagnoza je teška zbog odsustva simptomatologije. Agresivan je tumor sa recidivima, metastazama i letalnim ishodima, otporan na sve terapijske opcije osim hirurškog lečenja. Pacijentkinja, 48 godina, hipertenzivna, gojazna i pušač, početkom 2017. godine ukazuje na ovalnu tumefakciju na desnoj natkolenici, na lateralnoj strani, od polovine femura ka kolenu, okruženu celulitom, koja se sporo uvećavala. Promena nešto čvršće strukture, smeštena duboko podkožno. Ehosonografski subkutano od polovine femura ka kolenu vaskularizovana tumorska formacija, širine 80 mm, narušava arhitektoniku masnog tkiva i zahvata mišiće. Magnetna rezonanca prikazuje mekotkivnu infiltrativnu promenu, dominantno u podkožnom masnom tkivu. Prikazana vaskularnom, rekonstruktivnom hirurgu i ortopedu kojima promena imponuje kao dezmoidni tumor i određuju nastavak lečenja u referentnoj ustanovi. Tumor operativno odstranjen. Histopatološki odgovara high-grade primarnom malignom mezenhimalnom tumoru tipa dediferentovanog liposarkoma, sa lejomioblastičnom diferencijacijom. Pseudokapsula je infiltrovana vijabilnim tumorskim ćelijama, pa Sarkoma konzilijum ordinira adjuvantnu radioterapiju (50 Greja u 25 frakcija). Pacijentkinja se dobro oseća i obavlja kontrolne preglede. Za uspešan tretman liposarkoma neophodan je multidisciplinarni pristup hirurga, radioterapeuta, patologa, onkologa i specijaliste nuklearne medicine u specijalizovanim centrima.
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