BACKGROUND AND OBJECTIVES: Abdominal Aortic Aneurysm (AAA) and carotid disease have medical and social significance, considering their morbidity, disability, and economic consequences. The study objectives were to determine the prevalence of asymptomatic internal carotid artery (ICA) lesions > or =70% in patients with AAA, the correlation of AAA diameter with the degree of ICA stenosis and symptoms, and the importance of preventive ultrasound checkups. SUBJECTS AND METHODS: A prospective non-randomized controlled study including 740 patients, aged from 18-85 years, who were suitable for the inclusion and exclusion criteria and reported at the vascular laboratory of the Institute for Vascular and Endovascular Surgery, Clinical Center of Serbia from 1st of December 2011 to the 1st of November 2012. RESULTS: The prevalence of asymptomatic ICA stenosis > or =70% in patients with AAA is 10.8%. Male representatives have more symptomatic ICA stenosis > or =70%. Patients with small aneurysms more often have asymptomatic ICA stenosis > or =70%. The occurrence of symptoms of carotid disease was more prevalent among patients with ICA stenosis > or =70% compared to the group with stenosis <70%. There was no correlation found between the grade of ICA stenosis with the size of AAA. CONCLUSION: The prevalence of asymptomatic ICA stenosis > or =70% in patients with AAA is found to be 10.8%. Male patients with ICA stenosis > or =70% more often had symptoms of carotid disease. In the smaller aneurysms, ICA stenosis > or =70% occurs frequently, but without the symptoms of carotid disease, and there was no correlation between the size of AAA and the grade of ICA stenosis. Clinical implications of ICA imaging in patients with previously diagnosed AAA is necessary.
Aged ; Aneurysm ; Aortic Aneurysm, Abdominal ; Carotid Artery, Internal ; Carotid Stenosis ; Constriction, Pathologic ; Humans ; Male ; Prevalence ; Prospective Studies ; Serbia

OBJECTIVETo conduct a study on attitudes, knowledge, and use of complementary and alternative medicine (CAM) therapies in Serbia. Available data about CAM therapies in the region are scarce, opinions lacking from health sector. Balkan region countries had a delay in issuing national policies on CAM therapies.

METHODSThe questionnaire used was based on previously validated CAM Health Belief Questionnaire (CHBQ), formulated as 5-item Likert type scale, adjusted for local environment. Health care students and professionals were evaluated. The questionnaire comprehended 10 closed questions on attitudes, knowledge and use of CAM therapies. This survey was conducted in eight cities of Serbia, January 2010-July 2011. A total of 797 participants was included. The second group of participants was 145 healthcare professionals (50 academic staff, 64 clinical staff, 19 pharmacists, 6 other clinical branch specialists and 6 nurses). Data were collected by an interview. Examinees could acquire maximum of 70 points, 35 representing neutral attitude.

RESULTSStudents of dentistry (54.65±6.07) were better informed on CAM therapies than medicine students (50.26±7.92). Pharmacy students (51.16±7.10) accepted low-scientific CAM. Pharmacists scored better than university professors (55.12±6.55 vs. 50.29±9.50). Primary health care professionals had better awareness than pharmacists in dispensing pharmacies. Both groups of participants preferred use of vitamins over any other CAM therapy.

CONCLUSIONThese pioneering efforts in the region exposed weaknesses in CAM attitudes of current and future health care professionals. Nevertheless, awareness on alternative medicine treatment choices is growing among Balkan prescribers. Supportive legal framework would facilitate dissemination of CAM medical practices.

Attitude of Health Personnel ; Complementary Therapies ; utilization ; Cross-Sectional Studies ; Delivery of Health Care ; statistics & numerical data ; Health Knowledge, Attitudes, Practice ; Health Personnel ; Humans ; Serbia ; Students ; Surveys and Questionnaires

Although Serbia is recognized as an endemic country for echinococcosis, no information about precise incidence in humans has been available. The aim of this study was to investigate the skeletal manifestations of hydatid disease in Serbia. This retrospective study was conducted by reviewing the medical database of Institute for Pathology (Faculty of Medicine in Belgrade), a reference institution for bone pathology in Serbia. We reported a total of 41 patients with bone cystic echinococcosis (CE) during the study period. The mean age of 41 patients was 40.9+/-18.8 years. In 39% of patients, the fracture line was the only visible radiological sign, followed by cyst and tumefaction. The spine was the most commonly involved skeletal site (55.8%), followed by the femur (18.6%), pelvis (13.9%), humerus (7.0%), rib (2.3%), and tibia (2.3%). Pain was the symptom in 41.5% of patients, while some patients demonstrated complications such as paraplegia (22.0%), pathologic fracture (48.8%), and scoliosis (9.8%). The pathological fracture most frequently affected the spine (75.0%) followed by the femur (20.0%) and tibia (5.0%). However, 19.5% of patients didn't develop any complication or symptom. In this study, we showed that bone CE is not uncommon in Serbian population. As reported in the literature, therapy of bone CE is controversial and its results are poor. In order to improve the therapy outcome, early diagnosis, before symptoms and complications occur, can be contributive.
Adolescent ; Adult ; Aged ; Animals ; Bone Diseases/complications/epidemiology/*parasitology/radiography ; Child ; Child, Preschool ; Echinococcosis/complications/epidemiology/*parasitology/radiography ; Echinococcus granulosus/isolation & purification/physiology ; Humans ; Infant ; Middle Aged ; Retrospective Studies ; Serbia/epidemiology ; Young Adult

OBJECTIVES: Chronic otitis media (COM) is followed by irreversible tissue damage and destruction of the middle ear structures, with the possibility of complications under the maintenance of inflammation. Inflammatory mediators such as cytokines play a crucial role in the initial stage of inflammation. The aim of this study was to evaluate the association of the polymorphisms in two innate immunity/inflammation cascade genes from interleukin-1 (IL-1) gene cluster with COM with regard to cholesteatoma. METHODS: In the cross-sectional case-control study, DNA samples were collected from 189 patients with COM and 119 controls from a population of Serbia. The +3953 C/T (rs1143634), TaqI polymorphism in interleukin-1 beta (IL-1β) gene and 86 bp variable number tandem repeat (VNTR, rs2234663) polymorphism in the IL-1 receptor antagonist (IL-1RA) gene were analyzed by polymerase chain reaction. RESULTS: The IL-1β TaqI polymorphism was not significantly different in patients compared with the control group. The significant difference between patients and controls was observed for both, genotype and allele frequencies of IL-1RA VNTR polymorphism (chi-square P < 0.01). We found that carriers of IL-1RA allele 2 (odds ratio, 0.47; 95% confidence interval, 0.29 to 0.76; P=0.004) have a favorable association with COM, using multivariate logistic analysis that included both polymorphisms, age and sex. The IL-1RA allele frequency distribution was significantly different with regard to cholesteatoma. CONCLUSION: The carriers of allele 2 of VNTR IL-1RA polymorphism had a decreased odds ratio for COM, which is in agreement with findings in other inflammatory disease and its previous association with higher IL-1RA levels. Possible down-regulation of IL-1 mediated proinflammatory signaling pathways via IL-1RA in COM as well as results of our study should be further investigated and replicated.
Alleles* ; Case-Control Studies ; Cholesteatoma ; Cytokines ; DNA ; Down-Regulation ; Ear, Middle ; Gene Frequency ; Genotype ; Humans ; Inflammation ; Interleukin 1 Receptor Antagonist Protein* ; Interleukin-1 ; Interleukin-1beta ; Multigene Family ; Odds Ratio ; Otitis Media* ; Otitis* ; Polymerase Chain Reaction ; Polymorphism, Genetic ; Serbia ; Tandem Repeat Sequences