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BackgroundVertebral fractures could lead to reduced physical, social and mental functioning, and loss of personal independence. Therefore, during the treatment of osteoporosis, it has become necessary to examine the changes in everyday functioning, well-being and health related quality of life (HRQOL). To that effect, this study aims to translate, culturally adapt, and validate the Serbian version of Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41) for patients with vertebral fractures.MethodsNine female patients with osteoporosis participated in the pre-validation study. A validation, case–control study included two groups of female patients: one that consisted of 50 female patients with osteoporosis, and with at least one vertebral fracture, and another one that consisted of 50 control patients with osteoporosis but without fractures. They completed the QUALEFFO-41 and the EuroQol group questionnaire with five dimensions (EQ-5D) twice within a month. The validation study examined internal consistency, concurrent validity, test-retest reliability, sensitivity and specificity.ResultsDuring the pre-validation study, three of the items in the QUALEFFO-41 were slightly changed. Afterwards, during the validation study, the statistically significant differences (adjusted for: age, duration of menopause, current employment and marital status) in the mean values of all domains and total scores between the groups were noted. For the case group, the internal consistency of the QUALEFFO-41 domains and of total questionnaire was above 0.70. The test-retest reliability was tested by the intraclass correlation coefficients (ICC) that were in range 0.87 – 0.96 for the case, and 0.15 – 0.83 for the control group. Correlations between the total scores of the QUALEFFO-41 and the EQ-5D health state value, for both groups were negative and statistically significant (r = -0.78, p<0.001 and r = -0.73, p<0.001, respectively). The QUALEFFO-41 had a better prediction of the value of HRQOL of cases compared to the generic questionnaire EQ-5D (the AUC difference was 0.099, p = 0.013).ConclusionsThe Serbian QUALEFFO-41 version is reliable, valid, sensitive and predictive for examinations of HRQOL in patients with prevalent vertebral fractures and can be used in further studies.

AbstractThe aim of the paper was to examine the relation between bone density and certain parameters of lipid status in postmenopausal women. The research involved 300 women referred to densitometric examination as they belonged to the risk group of postmenopausal women. All the examinees had the following biochemical parameters determined: total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, glycemia, serum Ca and P. Univariate logistic regression analyses showed that each year of age, menopause duration, AH are significantly connected to risk increase for the appearance of osteopenia or osteoporosis. Increase in values of SBP, DBP, cholesterol, LDL and triglyceride are connected with significant risk increase for the appearance of osteopenia or osteoporosis. Patients with AH are connected to 11 times elevated risk for the appearance of osteopenia or osteoporosis, cigarette smoking increased the risk by seven times, physical inactivity even by 52 times, CVD in the family anamnesis by eight times, and osteoporosis in the family anamnesis is connected to the risk by four times. In our research, atherogenic lipoproteins negatively correlate with lumbar bone density. Disturbed lipide status is a risk factor for cardiovascular diseases, but also a risk factor for the appearance of osteoporosis.

Functional status evaluated by the HAQ is a standard for as- sessment of RA due to its convenience and good correlation with parameters of disease activity. The most significant factors that increase the odds that the patient has the greatest functional damage are DAS28 SE, DAS28 CRP and the pres- ence of CRP.

SummaryBy determining the prevalence of postural disorders among eighth grade school students it is possible to indicate the state of these disorders at the end of the elementary school level of education, and compare it to the results obtained by applying corrective treatments on high school students. Thus, the aim of the research was to determine the prevalence of postural disorders among eighth grade school children. The research was carried out on a sample of 101 eighth grade students of both genders, aged 14. The photometry method was used to determine the presence of any postural disorders. The research results indicated that a proportionally statistically significant large number of participants with postural disorders were identified. Of the total number of participants, 60.4% had postural disorders, the most prevalent of which was flat back (22.8%), kypho-lordosis, (20.8%), lordosis (9.9%) and kyphosis (6.9%). Analyzed in terms of gender, the percentage of the girls with postural disorders is statistically significantly greater than that of the boys. Due to the large number of children with postural disorders, the recommendation is that the evaluation of the postural status of students should take place not only at the elementary school age, but also at the high school age. In addition, evaluation alone is insufficient, and exercise programs to correct postural disorders are required as well.

The aim of this study is to determine the state of postural disorders in the sagittal and frontal planes of the spinal column, as well as any gender differences in first-year elementary school students. The participant sample comprised 138 school children, 73 male and 56 female participants, all from the territory of the municipality of Knjaževac, Serbia. The measuring instrument, the Formetric 4D System, Diers, Germany was used for the assessment of postural disorders of the spinal column. The testing results were presented in terms of frequencies and percentages, while the chi-square independence test was used to determine differences in spinal deformity incidence between male and female participants. The results obtained indicate that, in the sagittal plane, deformity was present in a total of 73.9% of the sample (72.6% among the male and 75.4% among the female participants), whereas in the frontal plane this percentage amounted to 84.1% (84.9% among the male, and 83.1% among the female ones). Moreover, the results indicate that no statistically significant differences were found in terms of the incidence of postural disorders between male and female participants in the sagittal plane (sig=0.859) and in the frontal plane of the spinal column (sig=0.949). In view of the results obtained, it can be concluded that a high incidence of spinal postural disorders in both the frontal and sagittal planes was equally present in participants of both genders.

The aim of the research was to contribute to better understanding of the correlation between postural disorders and muscle power in primary school children. The sample of respondents consisted of 1,120 children, aged 7 to 12 years (549 boys and 571 girls) from the territory of the municipality of Knjaževac. In the assessment of the spinal column status, the device "Spinal Mouse" (Switzerland) was used, while in the analysis of the status of the feet, the podoscope "Pedic" (Hungary) was used. A handheld dynamometer "Lafayette" (USA) and tensiometric force platform "Vernier Force Plate" (USA) were used in the analysis of muscle power. Spinal column and feet status were measured in the static condition, with children being in the upright standing position. Muscle power status was measured in both static (a clinician was applying muscle force to the dominant upper extremity of a child trying to overcome or "break" the child's muscle resistance) and dynamic conditions (Counter Movement Jump). Descriptive statistics and correlation analysis were used in data processing by the means of the SPSS software version 24. Results revealed poor postural and muscle power status, and correlations suggesting to possible kinetic chain reaction causing the disruption of the normal postural status in primary school children. Determined postural disorders are characterized by the early functional stage that can be reduced by appropriate corrective exercise programme application and augmented level of proper physical activity. Those programmes and activities are being guided and implemented by physicians and PE teachers in the municipality of Knjaževac.

AbstractRheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial inflammation and destruction of joint cartilage and bone. Different cytokines play important role in the processes that cause articular destruction and extra-articular manifestations in RA. The contribution of cytokines representing the Th1 (INF-γ), Th2 (IL-4) and IL-17A to the pathogenesis of early RA and bone mineral density (BMD) loss in still poorly understood. Serum samples of 38 early RA patients were evaluated for erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), C-reactive protein (CRP), anti-cyclic citrullinated peptide antibodies (anti-CCP) and for the tested cytokines (IL-17A, IL-4 and INF-γ). BMD was evaluated by dualenergyX-ray absorptiometry (DXA). Disease activity score (DAS28) calculation was assessed for all patients. Control serum samples were obtained from 34 healthy volunteers. The levels of tested cytokines were significantly higher (IL-17A, p<0.001; INF-γ, P<0.001; IL-4, P<0.01) in patients with early RA, compared to the healthy controls. In early RA patients, strong correlation of serum IL-17A was found with DAS28, ESR and CRP. Also, a significant negative correlation was found between serum INF-γ levels and the DAS28 score. Significantly positive correlation of BMD values and CRP, DAS28 IL-17A were also demonstrated. DXA analysis revealed that the most common site for osteoporosis was the lumbar spine followed by the femoral neck. BMD values significantly correlated with CRP, DAS28 score and IL-17A serum levels. The mean serum IL-17A levels, in patients with early RA, corresponded with disease activity, severity and BMD loss, indicating the potential usefulness of serum IL-17A in defining the disease activity and bone remodeling.