HEALTH CARE

COVID-19 VACCINATION ACCEPTANCE AMONG PRECLINICAL AND CLINICAL MEDICAL STUDENTS

2025-02-19T10:29:47+01:00

Introduction/Aim. Health workers and medical students played an important role in the COVID-19 pandemic, so their responsibility, knowledge and attitudes towards vaccination were very important in the pandemic. The aim of this study was to examine COVID-19 vaccination acceptance among medical students according to their study year.

Methods. In this cross sectional study 730 students of the Faculty of Medicine of the University of Belgrade participated, of which were 332 preclinical students (45.5%) and 398 (54.5%) clinical students. The study was conducted between December 1, 2022 and January 31, 2023 based on a specially designed questionnaire, which the students filled out anonymously and on a voluntary basis.

Results. The largest number of students declared that they have never been infected with COVID-19 (63.0%). Clinical students were significantly more vaccinated (94.5% vs 87.3%, p=0.001). As the most common reasons for vaccination, students state the desire to protect the people around them (64% preclinical and 71% clinical, p=0.594), availability of vaccine (27% preclinical and 33% clinical, p=0.407) and recommendation by healthcare workers (30% preclinical and 27% clinical, p=0.111). The most common reason for not receiving the vaccine were the suspicion that the vaccines have not been tested enough (52% preclinical and 59% clinical, p=0.407) and the fear of side effects (26% and 50%, p=0.059). Clinical medical students significantly more often regularly followed information about COVID-19 vaccine and received information from the Internet in comparison with preclinical students.

Conclusion. The obtained results show a high coverage of vaccination among preclinical and clinical medical students. Timely and accurate information through the media and social networks can contribute to preventing misinformation and help the public health system in future challenges and campaigns.

PREDICTORS OF DISEASE SEVERITY IN COVID-19 PATIENTS

2025-02-19T10:31:07+01:00

Background/aim: In the clinical picture of COVID-19 respiratory symptomatology dominates, but it is basically a multisystemic disorder. The aim of this study was to identify predictors of severe forms of COVID-19 defined as the need for assisted ventilation (non-invasive or invasive mechanical ventilation).

Methods: The research was conducted as a retrospective cohort study at the General hospital "Laza K. Lazarević” in Šabac for the period from1.4.2020. to 14.11.2020. The relationship between demographic and clinical parameters of patients and the need for assisted ventilation was examined by logistic regression analysis.

Results: The study included 516 patients, 334 male subjects (64.7%), with the age of 60 and over (52.7%). The most commonly reported symptoms were fever (89%) and generalized weakness (68.8%). Mechanical ventilation was required by 44 patients, majority of whom were male (64.7%). The dominant comorbidities in mechanically ventilated group were hypertension (63.6%) and diabetes (22.7%). According to multivariate analysis independent risk factors for assisted ventilation were: fever (p=0.016), duration of illness more than seven days before hospitalization (p=0.023), oxygen saturation (sO2) <90% (p=0.002), arrhythmia(p=0.001), leukocytosis(p=0.034), and CRP≥50 mg/l (p=0.002).

Conclusion: The risk of assisted ventilation was higher in patients with fever, sO2<90% on admission to hospital, duration of illness more than seven days before hospitalization, arrhythmia, leukocytosis, lymphopenia<1.0x10⁹and CRP>50 mg/l.

ASSESSMENT OF HEALTH LITERACY OF ADULTS RECEIVING THEIR HEALTH CARE AT THE PIROT HEALTH CENTER AND THE FACTORS THAT DETERMINE IT

2025-02-19T10:32:06+01:00

Introduction/Aim: Health literacy is a concept that has been gaining increasing importance in the field of public health and healthcare, even though it has been in use since the 1970s. The aim of this work is to assess the level of health literacy in the population of adult patients who receive their health care in the Pirot Health Center, as well as to identify factors that may be associated with the level of health literacy.

Methods: The research was conducted in the form of a cross-sectional study in the Pirot Health Center in the period from 1.5.2024. until 1.6. 2024. 400 respondents participated in the research. The general questionnaire and the European Health Literacy Questionnaire (HLS-EU-Q-47) were used as research instruments. The chi-square test was used in the statistical analysis of the data.

Results: Out of 400 adult health center respondents, 10.2% had inadequate, 15.8% problematic, 33.5% sufficient, and 40.5% excellent health literacy. Sufficient or excellent health literacy was statistically significantly associated with gender, age, place of residence, marital status and level of education. Persons with chronic diseases, as well as persons who personally assessed that they have poor and very poor health status, significantly more often had inadequate/problematic health literacy.

Conclusion: A low level of health literacy is a key barrier to the use of appropriate health care, which is why it is necessary to continuously work on the identification of groups with inadequate health literacy and their education.

PRIMARY ANGIOSARCOMA OF THE BREAST: A CASE REPORT

2025-02-19T10:33:25+01:00

Background/Aim: Breast angiosarcoma is a rare tumour of vascular endothelium origin, accounting for less than 0.05% of all breast malignancies. The aim of this case report was to point out the importance of early recognition and a multidisciplinary approach in the diagnosis and treatment of this rare entity.

Case report: A 44-year-old woman presented for a clinical examination due to a tumour in her right breast. After a mammographic examination, which verified a highly suspicious lobular change at the junction of the upper quadrant of the right breast with a diameter of 86 x 98 mm, a biopsy with a core needle was performed, followed by a radical mastectomy. Pathohistologically, a vascular mesenchymal tumor was verified. Using the immunohistochemical staining method, the tumor showed immunoreactivity to Vimentin, CD31, CD34, and Factor VIII, while AE1/AE3, EMA, estrogen, progesterone, and HER2 were negative, and the diagnosis of poorly differentiated primary angiosarcoma was made.

Conclusion: Primary breast angiosarcoma represents a real diagnostic challenge. Due to the tumor's rarity and aggressiveness, a multidisciplinary approach to diagnosis and treatment is essential. Because of the nonspecific clinical and radiographic features of primary angiosarcoma, differential diagnoses encompass both benign and malignant breast conditions. Therefore, histopathological analysis is crucial for accurate diagnosis.

ADVANTAGES AND DISADVANTAGES OF X-RAY DIAGNOSIS FOR WHOOPING COUGH PATIENTS

2025-02-19T10:35:39+01:00

The World Health Organization describes whooping cough as "a highly contagious disease of the respiratory tract caused by Bordetella pertussis," a microorganism specifically pathogenic to humans. Whooping cough affects all ages, especially children, and is one of the leading causes of death in children under one year of age. Incubation usually lasts 7 to 10 days, and the clinical picture depends on age and vaccination status. Whooping cough is often a challenge because of symptoms that are similar to those of other respiratory infections. In adults, the disease is usually asymptomatic mild symptomatic infection occurs, especially in the elderly who have been previously vaccinated. However, in children under 5 years of age, especially infants, the clinical picture is more severe. It is in the form of paroxysmal cough, which may be accompanied by characteristic wheezing or inspiratory whooping and vomiting or expelling a small amount of sticky mucus. Dyspnea, cyanosis and apnea. can also occur, especially in infants. The most common complication in unvaccinated children is bronchopneumonia. In order to diagnose the disease, in addition to the specific clinical picture, a nasopharyngeal swab or aspirate is most often used for PCR testing or bacterial cultivation and blood for serological analyses. X-ray of the lungs in persons with suspicion of whooping cough can play a significant role in the assessment of complications and differential diagnosis, and in children under four years of age, also in establishing the diagnosis. However, during chest X-ray imaging, coughing attacks during imaging, inability to detect the disease in the early stages, exposure of the patient to ionizing radiation, and errors in the interpretation of images may occure.

IS KNOWLEDGE OF DIABETES MELLITUS A PREREQUISITE FOR OPTIMAL SELF-CARE AND CONTROL OF THIS DISEASE?

2025-02-19T10:36:27+01:00

Diabetes mellitus (DM) is the most common endocrinological disease of the modern era of pandemic proportions. People with DM have an increased risk of premature death caused by cardiovascular and other diseases compared to the general population. Patients' knowledge about DM includes a series of beliefs about different aspects of the disease that patients have accumulated during their lifetime, before and after diagnosis. This knowledge represents a significant cognitive factor that can influence a person's adaptation to the disease, the course of the disease and its treatment. In this review, it was examined whether knowledge about DM is a prerequisite for optimal self-care and control of this disease. The literature search was conducted using the following key words: diabetes mellitus, self-management, knowledge and education in PubMed, Emabase, Scopus, SCIndex and Hrčak for the period from 2001 to 2024. The largest number of studies on DM patients' knowledge used the Diabetes Knowledge Questionnaire (DKQ) with 24 items. In patients with DM type 1 and DM type 2 who participated in these studies, ubiquitous, deficient knowledge about DM was observed, which the authors link to suboptimal blood glucose values, high morbidity and mortality of the patients. Family history of DM, younger age and college education were independent predictors of optimal knowledge of patients with DM in most studies. Routine assessment of the level of knowledge of patients with DM through standardized questionnaires, accompanying identification of vulnerable groups and their education would enable the improvement of the knowledge of patients and the acquisition of skills necessary for self-menagement.

mortalitet PREDICTORS OF TREATMENT OUTCOME OF SURGICAL PATIENTS IN THE INTENSIVE CARE UNIT: LITERATURE REVIEW

2025-02-19T10:37:25+01:00

Intensive care involves the care of life-threatening patients, i.e. care of critically ill patients who need intensive monitoring, treatment and care in order to maintain hemodynamic and respiratory balance, in order to reduce the number of complications and deaths. The aging of the population, the increased complexity of care, as well as the increasingly diverse pathology and symptomatology of certain diseases and conditions, influence the increase in the need for intensive care services in all branches of medicine, primarily in surgery. The aim of this review is to identify predictors of treatment outcomes for surgical patients in intensive care units (ICUs). Data were collected by searching several databases: PubMed, Google Scholar, Web of Science and Embase. A search was conducted for the past twenty years using the following keywords: intensive care unit, surgery, predictors, and treatment outcome. Included in our analysis were papers that analyzed the clinical outcomes of surgical patients who stayed in the ICU. It is observed that the predictors of the outcome of the treatment of surgical patients in ICU are: the severity of the patient's clinical picture before hospitalization, the type and scope of the operation, age, obesity, number of comorbidities, postoperative complications, but also the degree of organization of the health service and the competence of the health staff. Therefore, at the local, regional and global level, continuous monitoring and evaluation of predictors of treatment outcomes for surgical patients in the ICU should be developed, bearing in mind that life-threatening patients are hospitalized and that there is a high risk of complications and death. By identifying the predictors of the outcome of the treatment of surgical patients in the ICU, it will contribute to the adoption of strategies to improve the treatment of these patients.