Impact of quality of response on survival outcomes among multiple myeloma patients treated with novel agents - a retrospective analysis

Abstract BACKGROUND: In this era of target therapies, novel data on the correlation between response endpoints and survival outcomes in multiple myeloma have arisen. OBJECTIVE: To determine the impact of quality of response on clinical outcomes, using first-line treatment, and identify risk factors influencing progression-free survival (PFS) and overall survival (OS) among myeloma patients. DESIGN AND SETTING: Retrospective analysis on myeloma patients who were treated at the Clinic of Hematology and Clinical Immunology, University Clinical Centre, Niš, Serbia, over a four-year period. METHODS: A total of 108 newly diagnosed patients who received first-line therapy consisting of conventional chemotherapy or novel agent-based regimens were included in this analysis. RESULTS: The quality of response to first-line therapy for the whole cohort was classified as follows: complete response (CR) in 19%; very good partial response (VGPR) in 23%; partial response (PR) in 38%; and less than PR for the remaining patients. After a median follow-up of 25.4 months, the three-year PFS and OS for the entire study population were 47% and 70%, respectively. Achievement of CR was the main factor associated with significantly prolonged PFS and OS, in comparison with patients who reached VGPR and PR. Likewise, addition of the new drugs bortezomib and thalidomide to standard chemotherapy led to considerably extended PFS and OS, compared with conventional therapy alone. CONCLUSIONS: This analysis demonstrated that the quality of response after application of first-line treatment using novel agent-based regimens among multiple myeloma patients was a prognostic factor for PFS and OS, which are the most clinically relevant outcomes.

Risk factors for potential drug-drug interactions of statins in patients with acute coronary syndrome

Abstract The aim of our study was to assess risk factors for potential drug-drug interactions (pDDIs) of statins across different phases of treatment of acute coronary syndrome (ACS) patients: from the point of first medical contact to the coronary angiography (first phase), after coronary angiography to the last day of hospitalization (second phase) and at discharge from hospital (third phase). This was a post hoc analysis of the data collected during the retrospective observational cohort study conducted at the Clinic for Cardiology of the Clinical Centre Kragujevac, Serbia. Patients prescribed statins were identified from the original study population: 156, 240 and 236 patients for the first, second and third phases, respectively. At least one statin pDDI was present in 113 (72.4%), 161 (67.1%) and 139 (58.9%) patients in the first, second and third phases, respectively. Heart failure, arrhythmias after ACS, CRP, triglycerides, length of hospitalization, number of prescribed drugs, antiarrhythmic drugs, and clopidogrel seem to increase the risk of statin pDDIs in at least one treatment phase. Physicians should be vigilant to the possibility of statin pDDIs in ACS patients who have factors that may increase their rate.

Profile for body fat percentage of Serbian working population, aged from 18 to 65, measured by multichannel bioimpedance method / Perfil del porcentaje de grasa corporal de la población activa serbia, de 18 a 65 años, medido por el método de bioimpedancia multicanal

SUMMARY: Obesity prevalence and trends of PBF related to age were defined on a sample of 8100 people among whom, 4955 were male (Age = 31.2 ± 10 yr) and 3145 were female (Age = 32.1 ± 11.3 yr). Body structure measurements were performed using a standardized method of multichannel bioimpedance analysis (BIA), using a body structure analyzer - InBody 720. The total sample was divided into two subsamples according to sex, where every subsample was divided into five different age groups.The mean PBF values of the Male total sample were 18.2 ± 8.0 % and the female total sample was 28.3 ± 9.2 %. Results of Kruskal-Wallis ANOVA with Dwass-Steel-Critchlow-Fligner post-hock showed that there are statistically significant differences (p < 0.001) between all age groups among themselves except groups 50 - 60 and 60 - 65 (p = 0.09). Analysis of obesity prevalence according to the PBF indicator in different age groups revealed the existence of statistically significant (p < 0.001) trends of increasing obesity with age, both in men and women. Based on the result of this study, it can be concluded that most of the Serbian working population are in the range of normal PBF values, excluding the male 30-39.9 yr and female 60-65 yr age categories as groups which are more prone to obesity levels.

RESUMEN: La prevalencia de obesidad y las tendencias de PBF relacionadas con la edad se determinaron en una muestra de 8100 personas, de las cuales 4955 eran hombres (Edad = 31,2 ± 10 años) y 3145 eran mujeres (Edad = 32,1 ± 11,3 años). Las mediciones de la estructura corporal se realizaron utilizando un método estandarizado de análisis de bioimpedancia multicanal (BIA), usando un analizador de estructura corporal - InBody 720. La muestra total se dividió en dos submuestras, según el sexo, donde cada muestra se dividió en cinco grupos de edad diferentes. Los valores de PBF de la muestra total masculina fueron 18,2 ± 8,0% y la muestra total femenina fue 28,3 ± 9,2%. Los resultados del ANOVA de Kruskal-Wallis con Dwass-Steel-Critchlow- Fligner post-corvejón mostraron que existían diferencias estadísticamente significativas (p <,001) entre todos los grupos de edad, excepto los grupos 50 - 60 y 60 - 65 (p = 0.09). El análisis de la prevalencia de obesidad según el indicador PBF en diferentes grupos de edad, reveló la existencia de tendencias estadísticamente significativas (p < 0,001) de un aumento de la obesidad con la edad, tanto en los hombres como en las mujeres. Con base en el resultado de este estudio, se puede concluir que la mayoría de la población activa de Serbia se encuentra en el rango de valores normales de PBF, excluyendo las categorías de edad de hombres de 30 a 39,9 años y de mujeres de 60 a 65 años, como los grupos que son más propensos a los niveles de obesidad.

The influence of hypothermia prevention by application of skin moisture absorbent on the value of body temperature, body weight and blood parameters in piglets / A influência da prevenção da hipotermia pela aplicação de absorvente de umidade da pele no valor da temperatura corporal, peso corporal e parâmetros sanguíneos em leitões

Reducing the mortality rate is of a great economic importance for pig farming. Therefore, it is necessary to define the conditions in the farrowing unit based on the performance of the piglets, and specific hematological and biochemical parameters. Therefore, the aim of this paper is to examine the importance of using skin moisture absorbent and its influence in preventing hypothermia, which causes great economic losses in pig production. The experiment was set up on a commercial farm in Serbia and included 92 pigs divided into the experimental and control group. Body temperature values, body weight and blood parameters were monitored. The obtained values indicate that there is a significantly positive correlation of body temperature change and body weight values, and body temperature showed a significantly higher increase in the experimental group compared to the control group. The results obtained from hematological and biochemical parameters provide a clearer picture of the metabolic processes in piglets in the farrowing unit and can be used to further improve pig production and as a complement to genetic enhancement.(AU)

A redução da taxa de mortalidade é de grande importância econômica para a suinocultura. Portanto, é necessário definir as condições na unidade de parto com base no desempenho dos leitões, para serem parâmetros hematológicos e bioquímicos específicos. Portanto, o objetivo deste trabalho é examinar a importância do uso de absorvente de umidade na pele e sua influência na prevenção da hipotermia, que causa grandes perdas econômicas na produção de suínos. A experiência foi montada em uma fazenda comercial na Sérvia, e incluiu 92 porcos divididos no grupo experimental e de controle. Os valores de temperatura corporal, pesos corporais e parâmetros sanguíneos foram monitorados. Os valores obtidos indicam que existe uma correlação significativamente positiva entre os valores da temperatura corporal e dos pesos corporais, e a temperatura corporal mostrou um aumento significativamente maior no grupo experimental em comparação com o grupo de controle. Os resultados obtidos a partir de parâmetros hematológicos e bioquímicos fornecem uma imagem mais clara dos processos metabólicos em leitões na unidade de parto e podem ser usados para melhorar ainda mais a produção de suínos e como um complemento ao melhoramento genético.(AU)

Comparative study of anthropometric measurement and body composition between elite handball and volleyball players from the Serbian national league / Estudio comparativo de medición antropométrica y composición corporal entre jugadores de balonmano y voleibol de élite de la liga nacional Serbia

SUMMARY: The purpose of this study was to describe the anthropometric characteristics and body composition of elite handball and volleyball players from the Serbian national league as well as to make comparisons between them. Sixty males were enrolled, divided into three groups: 15 handball players, 14 volleyball players, and 31 healthy sedentary subjects. All subjects were assessed for the anthropometric measures required for the calculation of body composition variables, using the standardized procedures recommended by established literature. Data were analysed using SPSS, and the descriptive statistics were expressed as a mean (SD) for each variable, while the ANOVA and LSD Post Hoc tests were carried out to detect the effects of each type of sport. The results showed there was no significant difference for body weight and body mass index, nor were there any differences for the bone contents of bodies among the groups, while significant differences were found for body height, as well as for muscle and fat content of body among the groups. These findings may give coaches from the region better working knowledge and enable them to follow recent selection process methods and to be more careful during talent identification.

RESUMEN: El objetivo de este estudio fue describir las características antropométricas y la composición corporal de los jugadores de balonmano y voleibol de élite de la liga nacional serbia, y realizar comparaciones entre ellos. Se evaluaron sesenta hombres divididos en tres grupos: 15 jugadores de balonmano, 14 jugadores de voleibol y 31 sujetos sedentarios sanos. Se evaluaron las medidas antropométricas de todos los sujetos requeridas para el cálculo de las variables de composición corporal, utilizando los procedimientos estandarizados recomendados por la literatura establecida. Los datos se analizaron mediante SPSS y las estadísticas descriptivas se expresaron como media (DE) para cada variable, mientras que se realizaron las pruebas ANOVA y LSD Post Hoc para determinar los efectos de cada tipo de deporte. Los resultados mostraron que no hubo diferencias significativas para el peso corporal y el índice de masa corporal, ni hubo diferencias para el contenido óseo de los cuerpos entre los grupos, mientras que se encontraron diferencias significativas de altura corporal, así como para el contenido de músculo y grasa corporal. Estos hallazgos pueden proveer un mejor conocimiento de trabajo a los entrenadores de la región y permitirles seguir los métodos recientes del proceso de selección y estar más atentos durante la identificación de talentos.

Morphometric analysis of the palpebral fissure and canthal distance in Serbian young adults / Análisis morfométrico de la fisura palpebral y la distancia cantal en adultos jóvenes serbios

SUMMARY: Frontaly and anteriorly the orbit is closed by a skin-muscular closure of eyelids. The eyelids limit the palpebral fissure, which is subject to geographical, racial, and age variations. As a part of the face, eyelids and palpebral fissure play a very important role in the attractiveness of the individual, but al so in the diagnosis of certain local and systemic pathological processes. The aim of the study was to perform a morphometric analysis of the palpebral fissure in a young population without pathological conditions and syndromes. The study was conducted on 90 subjects (45 male and 45 female) aged 19.28±0.69 years. Subjects were photographed with a Nikon D3400 camera, and the morphometric parameters were measured with the ImageJ 1.48v software. Statistical analysis of the data was performed in Windows Excel. The measurements in the study were the distance between the mid-points of both pupils, distance between both external canthi, distance between both internal canthi, palpebral fissure width and palpebral fissure height at three points. The average height of the palpebral fissure to the right is 9.35±1.55 mm and to the left is 9.41±1.56 mm. The average width of the palpebral fissure on the right is 27.05±1.71 mm and on the left is 27.18±1.68 mm. It was found that there was some difference in the measured parameters, however, this difference was not statistically significant.

RESUMEN: El músculo orbicular de los ojos se encuentra en la cara, delante de la órbita y debajo de la piel. Los párpados limitan la fisura palpebral, la abertura natural, sujeta a variaciones geográficas, raciales y de edad. Los párpados y la fisura palpebral juegan un papel importante en la estética de las personas, pero también en el diagnóstico de ciertos procesos patológicos locales y sistémicos. El objetivo del estudio fue realizar un análisis morfométrico de la fisura palpebral en una población joven sin enfermedades o condiciones patológicas. El estudio se realizó en 90 sujetos (45 hombres y 45 mujeres) de 19,28 ± 0,69 años. Los sujetos fueron fotografiados con una cámara Nikon D3400, y los parámetros morfométricos se midieron con el software ImageJ 1.48v. El análisis estadístico de los datos se realizó en Windows Excel. Se midieron la distancia entre los puntos medios de ambas pupilas, la distancia entre ambos cantos laterales, la distancia entre ambos cantos mediales, el ancho de la fisura palpebral y la altura de la fisura palpebral en tres puntos. La altura promedio de la fisura palpebral a la derecha fue 9,35 ± 1,55 mm y a la izquierda fue 9,41 ± 1,56 mm. El ancho promedio de la fisura palpebral a la derecha era 27,05 ± 1,71 mm y a la izquierda era 27,18 ± 1,68 mm. Se determinó una diferencia leve en los parámetros medidos, sin embargo, esta diferencia no fue estadísticamente significativa.

Morphology of the pterion in Serbian population / Morfología del pterion en población serbia

The pterion is a topographic point on the lateral aspect of the skull where frontal, sphenoid, parietal and temporal bones form the H or K shaped suture. This is an important surgical point for the lesions in anterior and middle cranial fossa. This study was performed on 50 dry skulls from Serbian adult individuals from Department of Anatomy, Faculty of Medicine in Novi Sad. The type of the pterion on both sides of each skull was determined and they are calcified in four types (sphenoparietal, frontotemporal, stellate and epipteric). The distance between the center of the pterion and defined anthropological landmarks were measured using the ImageJ software. Sphenoparietal type is predominant with 86 % in right side and 88 % in left side. In male skulls, the distance from the right pterion to the frontozygomatic suture is 39.89±3.85 mm and 39.67±4.61 mm from the left pterion to the frontozygomatic suture. In female skulls the distance is 37.38±6.38 mm on the right and 35.94±6.46 mm on the left. The shape and the localization of the pterion are important because it is an anatomical landmark and should be used in neurosurgery, traumatology and ophthalmology.

El pterion es un punto topográfico en la cara lateral del cráneo donde los huesos frontales, esfenoides, parietales y temporales forman la sutura en forma de H o K. Este es un punto quirúrgico importante para las lesiones en la fosa craneal anterior y media. Este estudio se realizó en 50 cráneos secos de adultos serbios del Departamento de Anatomía de la Facultad de Medicina de Novi Sad. Se determinó el tipo de pterión en ambos lados de cada cráneo y se calcifican en cuatro tipos (esfenoparietal, frontotemporal, estrellado y epipterico). La distancia entre el centro del pterion y los puntos de referencia antropológicos definidos se midió utilizando el software ImageJ. El tipo esfenoparietal es predominante con 86 % en el lado derecho y 88 % en el lado izquierdo. En los cráneos masculinos, la distancia desde el pterion derecho hasta la sutura frontocigomática es 39,89 ± 3,85 mm y 39,67 ± 4,61 mm desde el pterion izquierdo hasta la sutura frontocigomática. En los cráneos femeninos, la distancia es 37,38 ± 6,38 mm a la derecha y 35,94 ± 6,46 mm a la izquierda. La forma y la localización del pterion son importantes debido a que es un indicador anatómico y debe usarse en neurocirugía, traumatología y oftalmología.

Morphological and morphometric analysis of the external aperture of the carotid canal in Serbian population / Análisis morfológico y morfométrico de la apertura externa del canal carotídeo en la población Serbia

The carotid canal is located in the petrous part of the temporal bone and transmits the internal carotid artery along with the venous and sympathetic nerve plexus. The shape, location and dimensions of the carotid canal are clinically very important especially in cases of skull base surgery. The aim of this study was to investigate the morphological and morphometric parameters of the external aperture of the carotid canal in Serbian population. The study included 24 dry adult skulls and 36 dry adult temporal bones. Diameters and distances of the external aperture of the carotid canal from various important landmarks of the skull base were measured. The shape of the external carotid canal aperture was also noted. Digital data were processed in the ImageJ software. The average length of the external aperture of the carotid canal in all investigated specimens (skulls and temporal bones) on the right and left sides was 7.31±1.01 mm and 7.71±1.06 mm, respectively. The average width of the external aperture of the carotid canal on the right side was 5.82±0.78 mm while on the left side was 6.20±1.04 mm. The frequency of different shapes of the external aperture of the carotid canal was as follows: round in 45 (53.57 %), oval in 25 (29.76 %), and the rarest was almond shape noted in 13 (15.47 %) cases. There were no statistically significant differences in all measured parameters between genders and body sides. The only statistical significance was found in females between right and left side in relation with length (AP diameter) of the external aperture of the carotid canal. The results of this study will be useful for neurosurgeons to improve different surgical approaches to the petrous part of the internal carotid artery and prevent its complications.

El conducto carotídeo se encuentra en la parte petrosa del hueso temporal y da paso a la arteria carótida interna junto con el plexo nervioso venoso y simpático. La forma, ubicación y dimensiones del canal carotídeo son clínicamente muy importantes, especialmente en casos de cirugía de la base del cráneo. El objetivo de este estudio fue investigar los parámetros morfológicos y morfométricos de la apertura externa del canal carotídeo en la población serbia. El estudio incluyó 24 cráneos adultoss y 36 huesos temporales adultos secos. Se midieron los diámetros y distancias de la apertura externa desde varios puntos de referencia de la base del cráneo. También se observó la forma de la apertura del canal carotídeo externo. Los datos digitales se procesaron con Software ImageJ. La longitud promedio de la apertura en todos los especímenes investigados (cráneos y huesos temporales) en los lados derecho e izquierdo fue de 7,31 ± 1,01 mm y 7,71 ± 1,06 mm, respectivamente. El ancho promedio de la apertura en el lado derecho fue de 5,82 ± 0,78 mm mientras que en el lado izquierdo fue de 6,20 ± 1,04 mm. La frecuencia de las diferentes formas de la abertura externa fue la siguiente: redonda en 45 (53,57 %), ovalada en 25 (29,76 %), y la más rara fue la forma de almendra observada en 13 (15,47 %) casos. No hubo diferencias estadísticamente significativas en todos los parámetros medidos entre sexos y lados del cuerpo. La única estadística significativa se encontró en las mujeres entre el lado derecho e izquierdo en relación con la longitud (diámetro AP) de la apertura externa del conducto carotídeo. Los resultados de este estudio serán útiles para un mejor enfoque quirúrgico de los neurocirujanos en la parte petrosa de la arteria carótida interna, y advertir posibles complicaciones.

Profile and reference values for body fat and skeletal muscle mass percent at females, aged from 18.0 to 69. 9, measured by multichannel segmental bioimpedance method: Serbian population study / Perfil y valores de referencia del porcentaje de grasa corporal y masa muscular en mujeres, con edades comprendidas entre 18, 0 y 69, 9 años, medido por el método de bioimpedancia segmentaria multicanal: estudio en población serbia

Profile and standards for the diagnostics of percent of body fat and muscles were defined on a sample of 1924 women from the Republic of Serbia, aged 18.0 to 69.9, where the body structure of subjects was measured by applying multichannel segmental bioimpedance. Total sample was divided into six age groups, for the purpose of the definition of standard with regards to age. When it comes to body fat percentage results have shown that the average value of the total sample was 28.51±9.26 %, and between the range of 23.81 and 39.94 % for age groups 18.0-19.9 yr and 60.0-69.9 yr, respectively. Regression analysis results have shown that the constant of body fat percentage increase by trend of 3.417 % per decade, and that 25.1 % of mutual variance trend was explained by the model, with prediction error of 4.55 %. With regards to the percentage of skeletal muscles in the body, the results have shown that the average value of the total sample was 39.30±5.25 %, and within the range of 42.25 to 32.58 % for age groups 18.0-19.9 yr and 60.0-69.9 yr, respectively. Regression analysis results have shown that the constant of the skeletal muscles decrease by tend of -2.016 % per decade and that the model explained 23.8 % of mutual variance trend with prediction error of 8.08 %.

El perfil y estándares para el diagnóstico del porcentaje de grasa corporal y masa muscular fueron definidos en una muestra de 1924 mujeres de la República de Serbia, con edades comprendidas entre 18,0 y 69,9 años, donde la composición corporal de los sujetos fue medida por bioimpedancia segmentaria multicanal. La muestra fue dividida en seis grupos, con el propósito de definir los estándares respecto a la edad. Respecto al porcentaje de grasa corporal los resultados han mostrado que el valor promedio de la muestra fue de 28,51±9,26 %, y entre los rangos de 23,81 y 39,94 para los grupos de edad de 18,0-19,9 años y 60,069,9 años, respectivamente. Los resultados del análisis de regresión mostraron que la constante del porcentaje de grasa corporal aumentó 3,417 % por década, y que un 25,1 % de la varianza fue explicada por el modelo, con un error de predicción de 4,55 %. Con respecto al porcentaje de masa muscular, los resultados han mostrado que el valor promedio de la muestra fue de 39,30±5,25 %, y entre los rangos de 42,24 y 32,58 para los grupos de edad de 18,0-19,9 años y 60,0-69,9 años, respectivamente. Los resultados del análisis de regresión han mostrado que la constante de masa muscular decreció -2,016 % por década y que el modelo explicó 23,8 % de la varianza con un error de predicción de 8,08 %.

Adolescents' self perceived acne-related beliefs: from myth to science

Abstract Background: Acne vulgaris is recognized as the third most prevalent skin disease worldwide, with highest prevalence among adolescents. Beliefs and perceptions of adolescents about acne are incoherent in the literature. Objectives: To assess the most frequently reported acne-related beliefs in adolescents in order to focus on misconceptions and develop proper recommendations. Methods: A cross-sectional community-based study on representative sample of 2516 schoolchildren was conducted in six randomly selected secondary schools in Belgrade, Serbia. Only schoolchildren with present or past acne history participated. Factors believed to aggravate or ameliorate acne were recorded and analyzed, and the comparisons between girls and boys were evaluated using Pearson's chi-squared test. Results: A total of 1452 schoolchildren with acne participated, aged 14-18 years, among them 801 (55.2%) girls and 651 (44.8%) boys. Boys significantly more frequently believed that sweating, exercise, and dairy foods aggravate acne, whereas girls significantly more frequently blamed emotional stress, sweets, fatty foods, sun, and lack of sleep. The top four amelioration factors were as follows: comedone extraction, healthy diet, sun exposure, and increased water consumption. Acne regression was more frequently perceived to be linked with cigarettes in boys, but with sun exposure and weight loss in girls. Study limitations: The narrow age span of adolescents (14-18 years) and exclusion of acne-free adolescents are limitations due to study design. Conclusion: This survey is part of the first epidemiological study on a representative sample in the Western Balkan region. The significance of the most frequent acne-related beliefs is discussed and myths about acne are highlighted.

Prevalence and surgical management of pubic hypertrophy in hypospadias patients: results from a high-volume surgeon

ABSTRACT Introduction: Pubic hypertrophy, defined as an abnormal and abundant round mass of fatty tissue located over the pubic symphysis, is frequently underestimated in patients with hypospadias. We examined the prevalence of this condition, as well as the outcomes associated with its surgical treatment. Material and methods: Within 266 hypospadias patients treated at our clinic, we assessed the prevalence of pubic hypertrophy, and we schematically described the surgical steps of pubic lipectomy. Multivariable logistic regression (MLR) tested for predictors of pubic hypertrophy. Finally, separate MLRs tested for predictors of fistula and any complications after pubic lipectomy. Results: Of 266 hypospadias patients, 100 (37.6%) presented pubic hypertrophy and underwent pubic lipectomy. Patients with pubic hypertrophy more frequently had proximal hypospadias (44 vs. 7.8%), disorders of sex development (DSD) (10 vs. 0.6%), cryptorchidism (12 vs. 2.4%), and moderate (30°-60°) or severe (>60°) penile curvature (33 vs. 4.2%). In MLR, the location of urethral meatus (proximal, Odds ratio [OR]: 10.1, p<0.001) was the only significant predictor of pubic hypertrophy. Finally, pubic lipectomy was not associated with increased risk of fistula (OR: 1.12, p=0.7) or any complications (OR: 1.37, 95% CI: 0.64-2.88, p=0.4) after multivariable adjustment. Conclusions: One out of three hypospadias patients, referred to our center, presented pubic hypertrophy and received pubic lipectomy. This rate was higher in patients with proximal hypospadias suggesting a correlation between pubic hypertrophy and severity of hypospadias. Noteworthy, pubic lipectomy was not associated with increased risk of fistula or any complications.

Comparative study of morphological characteristics and body composition between different team players from Serbian junior national league: soccer, handball, basketball and volleyball / Estudio comparativo de las características morfológicas y composición corporal entre diferentes jugadores de equipos de la liga nacional junior de Serbia: fútbol, balonmano, baloncesto y voleibol

The purpose of this study is to define every subsample with precision, to give an overview of the importance of the differences between different team players, as well as to point to the closeness along with the remoteness between them, and finally, to determine latent anthropologic characteristics which, when in interaction, contribute to significant differences and better comprehension of the specifics of every mentioned sport. Sixty-seven males were enrolled in the study, divided into four groups: twenty-five soccer players, fifteen handball players, thirteen basketball players and fourteen volleyball players. All subjects were assessed for the anthropometric measures required for the calculation of body composition variables, using the standardized procedures recommended by the established literature. Data was analysed using SPSS and the descriptive statistics were expressed as a mean (SD) for each variable, while the ANOVA and LSD Post Hoc tests were carried out to detect the effects of each type of sport, distinct features that have been identified by calculating the discrimination coefficient have determined the specifics of the subsamples, and their grouping was demonstrated by calculating Mahalanobis distance. The results showed that a significant difference was found for body height, body weight, muscle contents of body, fat contents of body, residue mass, ideal body mass and lean body mass. There is no significant difference in the body mass index and bone contents of body. It was confirmed that there is a clearly defined line between the players in different sports and it is possible to determine the characteristics of players of each sport. The results also indicate that the least amount of differences appears between volleyball and basketball, and that the sports that are most apart are volleyball and handball. Therefore, these findings may give coaches from the region a more precise top soccer, handball, basketball and volleyball player profile, and suggest them to follow recent selection process methods and be more careful during talent identification.

El propósito de este estudio fue definir cada submuestra con precisión, para presentar una visión general de la importancia de las diferencias entre los distintos jugadores, así como para señalar la cercanía y la distancia entre ellos y, finalmente, para determinar la antropología latente. Estas características cuando están en interacción, contribuyen a encontrar diferencias significativas y mejorar la comprensión de las características específicas de cada deporte mencionado. Sesenta y siete hombres se inscribieron en el estudio, divididos en cuatro grupos: 25 jugadores de fútbol, 15 jugadores de balonmano, 13 jugadores de baloncesto y 14 jugadores de voleibol. Se evaluaron las medidas antropométricas de todos los sujetos para calcular las variables de composición corporal, utilizando los procedimientos estandarizados recomendados por la literatura establecida. Los datos se analizaron mediante SPSS y las estadísticas descriptivas se expresaron como una media (DE) para cada variable, mientras que las pruebas ANOVA y LSD Post Hoc se realizaron para detectar los efectos de cada tipo de deporte. Distintas características se han identificado mediante el cálculo del coeficiente de discriminación, determinando los detalles de las submuestras, y su agrupación se demostró al calcular la distancia de Mahalanobis. Los resultados mostraron que se encontró una diferencia significativa en la altura del cuerpo, el peso corporal, el contenido muscular del cuerpo, la grasa corporal, la masa residual, la masa corporal ideal y la masa corporal magra. No se observó una diferencia significativa en el índice de masa corporal y el contenido óseo del cuerpo. Se confirmó que existe una línea claramente definida entre los jugadores en diferentes deportes y es posible determinar las características de los jugadores de cada deporte. Los resultados también indicaron que la menor cantidad de diferencias aparece entre el voleibol y el baloncesto, y que los deportes que más se distinguen son el voleibol y el balonmano. Por lo tanto, estos hallazgos pueden darles a los entrenadores de la región, un perfil más preciso de los jugadores de fútbol, balonmano, baloncesto y voleibol, y sugerir que sigan métodos de selección recientes y considerar con mayor atención la identificación del talento.

Relationship between socioeconomic and nutritional status in the Serbian adult population: a cross-sectional study

ABSTRACT BACKGROUND: Socioeconomic status is a well-known risk factor for obesity. The aim of this study was to assess the relationship between socioeconomic and nutritional status in the Serbian adult population. DESIGN AND SETTING: Cross-sectional study on data from the 2013 National Health Survey performed in Serbia. METHODS: The study population consisted of adults aged ≥ 20 years. Face-to-face interviews and anthropometric measurements were conducted by trained staff. Associations between body mass index and sociodemographic variables were analyzed using multivariable logistic regression analyses. RESULTS: Out of 12,461 subjects of both sexes, 36.4% were overweight and 22.4% were obese. The prevalences of overweight and obesity differed significantly between the sexes, regarding all sociodemographic characteristics. Among women, educational attainment was associated with lower risk of being overweight (odds ratio, OR = 0.82; 95% confidence interval, CI: 0.69-0.98 for medium-level and OR = 0.77; CI: 0.62-0.97 for higher education) or obese (OR = 0.68; CI: 0.57-0.82 for medium-level and OR = 0.41; CI: 0.31-0.54 for higher education). In contrast, medium-level (OR = 1.28; CI: 1.08-1.52) and highly educated men (OR = 1.39; CI: 1.11-1.74) were more frequently overweight than were those with low education. Among men, grade I obesity was positively related to the richest wealth index group (OR = 1.27), while the opposite was true for grade II obesity among women (OR = 0.61). CONCLUSION: This study showed significant socioeconomic inequalities in nutritional status between men and women. Continuous monitoring of socioeconomic patterns relating to weight is important, especially with further exploration of the link between education and obesity.

Lazarevic-Lasègue sign / Sinal de Lazarevic-Lasègue

ABSTRACT Charles Lasègue is reputed to have described the test/sign bearing his name, but he never wrote about it and misinterpreted its mechanism. The purpose of this note is to highlight the work of the Serbian, Laza Lazarević, who was first to present the original report of this seminal sign in sciatica and provide its appropriate pathophysiological interpretation.

RESUMO Charles Lasègue guarda a reputação de ter descrito o sinal que leva seu nome, mas nunca escreveu sobre isso e interpretava erradamente sua etiopatogenia. O propósito desta nota é chamar atenção para o trabalho do sérvio Laza Lazarević, que apresentou a descrição original do sinal mais importante na ciatalgia e forneceu a interpretação apropriada da sua fisiopatologia.

Presentation of the trepanned skull labelled MO-90, found in the Avar cemetery on the territory of settlements Ómoravica-Kopláló in Serbia / Presentación de cráneo trepanado etiquetado MO-90, encontrado en el cementerio de Avar en territorio de los asentamientos Ómoravica-Kopláló en Serbia

SUMMARY: The most prominent issues in paleopathology concerning skull lesions are skull trepanation and artificial deformation of the skull. From the very beginnings of this scientific field, these two groups of alterations have been the focus of interest. Since the second half of the 19th century, countless pathologists, surgeons and ethnologist have dealt with this issue. The interest is still great. Nevertheless, numerous questions regarding skull trepanation and artificial deformation are yet to be answered. The first trepanned skull finds were discovered in France and Hungary. The finds in Hungary are interesting because a large number of trepanned skulls were found in a relatively small area. On the skull remains found in the grave discovered in the Òmoravica-Koplaló cemetery and labelled MO-90, left of the Sutura sagittalis there is a hole about 1cm in diameter. There are no pathological lesions along the edge or around the hole.

RESUMEN: Los temas más destacados en la paleopatología con respecto a las lesiones del cráneo son la trepanación y la deformación artificial éste. Desde los comienzos en esta área científica, estos dos grupos de alteraciones han sido el foco de interés. Desde la segunda mitad del siglo XIX, un número importante de patólogos, cirujanos y etnologistas se han enfocado e interesado en este tema. Sin embargo, aún existen preguntas y numerosas dudas sobre la trepanación del cráneo y la deformación artificial. Los primeros hallazgos de cráneos trepanados se descubrieron en Francia y Hungría. Los hallazgos en Hungría son interesantes debido a que es un área relativamente pequeña, pero fueron encontrados una gran cantidad de cráneos trepanados. En los restos de cráneos encontrados en la tumba del cementerio Òmoravica-Koplaló y etiquetados como MO-90, a la izquierda de la sutura sagital se observó un foramen de aproximadamente 1 cm de diámetro. No hay lesiones patológicas a lo largo del margen, tampoco alrededor del foramen.

The Allele 2 of the VNTR Polymorphism in the Gene That Encodes a Natural Inhibitor of IL-1β, IL-1RA Is Favorably Associated With Chronic Otitis Media

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.

Calcaneus quantitative ultrasound and body composition in preschool children: physical activity consideration / Ultrasonido cuantitativo de calcáneo y composición corporal en niños preescolares: consideración de actividad física

SUMMARY: The aim of this research was to determine the difference in Calcaneus quantitative ultrasound (QUS) and body composition according to physical activity in preschool children. We recruited 296 healthy children (112 girls and 184 boys) from different kindergartens in Vojvodina, Serbia. Children were evaluated for body composition. Quantitative ultrasound (QUS) measurements of the heel were performed using the Speed of sound, Broadband Ultrasound Attenuation, Quantitative Ultrasound Index and Estimated bone mineral density for further analysis. Furthermore, children were divided into three groups according to physical activity. Apart from the differences in Body fat % and body mass, there were no significant group differences for BMI, waist circumference and abdominal skinfold (p>0.05). The ANOVA showed significant differences (p<0.05) in all QUS measurements between three different intensities of physical activity. The results show that Body Mass and Body fat % were important predictors that discriminate children according to physical activity. Moreover, the results show that beside BMI and Body fat %, all calcaneus QUS measurements showed differences according to physical activity. In conclusion, our study showed differenses in all calcaneus QUS measurements according to physical activity level.

RESUMEN: El objetivo de esta investigación fue determinar la diferencia entre el ultrasonido cuantitativo (USC) de calcáneo y la composición corporal según la actividad física en niños en edad preescolar. Se estudiaron 296 niños sanos (112 niñas y 184 niños) de diferentes jardines infantiles en Vojvodina, Serbia. Se evaluó la composición corporal de los niños. Las medidas de USC del talón se realizaron utilizando la velocidad del sonido, atenuación de ultrasonido de banda ancha, el índice de ultrasonidos cuantitativos y la densidad mineral ósea estimada para un análisis posterior. Los niños se dividieron en tres grupos según actividad física. Además de las diferencias de porcentaje de grasa corporal y masa corporal, no se observaron diferencias significativas de grupo en el índice de masa corporal (IMC), circunferencia de cintura y el pliegue abdominal (p> 0,05). El test de ANOVA mostró diferencias significativas (p <0,05) en todas las mediciones USC entre tres diferentes intensidades de actividad física. Los resultados muestran que la masa corporal y la grasa corporal fueron indicadores importantes que permiten diferenciar a los niños según la actividad física. Por otra parte, los resultados muestran que además del IMC y el porcentaje de grasa corporal, todas las mediciones de USC del calcáneo mostraron diferencias según el nivel de actividad física. En conclusion, nuestro estudio mostró diferencias en el USC de acuerdo al nivel de actividad física.

Frequency of COPD in health care workers who smoke / Frequência de DPOC em profissionais de saúde que fumam

ABSTRACT Objective: COPD is one of the major causes of morbidity and mortality worldwide. Health care providers should counsel their smoking patients with COPD to quit smoking as the first treatment step. However, in countries with high prevalences of smoking, health care workers may also be smokers. The aim of this study was to determine the frequency and severity of COPD in health care workers who smoke. Methods: This was a cross-sectional study. All health care workers who smoke, from nine health care centers in Serbia, were invited to participate in the study and perform spirometry. The diagnosis of COPD was based on a post-bronchodilator FEV1/FVC ratio of < 0.70. All patients completed the COPD Assessment Test and the Fagerström Test for Nicotine Dependence. Results: The study involved 305 subjects, and 47 (15.4%) were male. The mean age of the participants was 49.0 ± 6.5 years. Spirometry revealed obstructive ventilatory defect in 33 subjects (10.8%); restrictive ventilatory defect, in 5 (1.6%); and small airway disease, in 96 (31.5%). A diagnosis of COPD was made in 29 patients (9.5%), 25 (86.2%) of whom were newly diagnosed. On the basis of the Global Initiative for COPD guidelines, most COPD patients belonged to groups A or B (n = 14; 48.2%, for both); 1 belonged to group D (3.6%); and none, to group C. Very high nicotine dependence was more common in those with COPD than in those without it (20.7% vs. 5.4%, p = 0.01). Conclusions: In this sample of health care workers, the frequency of COPD was comparable with that in the general population. The presence of COPD in health care workers who smoke was associated with higher nicotine dependence.

RESUMO Objetivo: A DPOC é uma das principais causas de morbidade e mortalidade em todo o mundo. Os provedores de cuidados de saúde deveriam aconselhar seus pacientes fumantes com DPOC a parar de fumar como primeiro passo de tratamento. Entretanto, em países com altas prevalências de tabagismo, os profissionais de saúde também podem ser fumantes. O objetivo deste estudo foi determinar a frequência de DPOC e sua gravidade em profissionais de saúde que fumam. Métodos: Trata-se de um estudo transversal. Todos os profissionais de saúde fumantes de nove centros de saúde na Sérvia foram convidados a participar do estudo e realizar espirometria. O diagnóstico de DPOC baseou-se em VEF1/CVF pós-broncodilatador < 0,70. Todos os pacientes preencheram o COPD Assessment Test e o Fagerström Test for Nicotine Dependence. Resultados: Participaram do estudo 305 indivíduos, e 47 (15,4%) eram do sexo masculino. A média de idade dos participantes foi de 49,0 ± 6,5 anos. A espirometria revelou defeito ventilatório obstrutivo em 33 indivíduos (10,8%), defeito ventilatório restritivo em 5 (1,6%) e doença das vias aéreas pequenas em 96 (31,5%). O diagnóstico de DPOC foi feito em 29 pacientes (9,5%), 25 (86,2%) dos quais foram recém-diagnosticados. Com base nas diretrizes da Global Initiative for Chronic Obstructive Lung Disease, a maioria dos pacientes com DPOC ficou no grupo A ou B (n = 14; 48,2%, para ambos); 1 ficou no grupo D (3,6%) e nenhum ficou no grupo C. Um grau muito alto de dependência de nicotina foi mais comum nos indivíduos com DPOC que naqueles sem a doença (20,7% vs. 5,4%; p = 0,01). Conclusões: Nesta amostra de profissionais de saúde, a frequência de DPOC foi comparável à observada na população geral. A presença de DPOC em profissionais de saúde que fumam relacionou-se com maior dependência de nicotina.

Changes in morphological characteristics during the period 2005 ­ 2014 in a sample of Serbian 7 - year-old children / Cambios en las características morfológicas durante el período 2005 - 2014 en una muestra de niños serbios de 7 años de edad

Morphological characteristics of children commonly imply the processes of growth and development. Information on children's growth in height and their body weight is often used as the indicator of the children's health and nutritional status. As the parameters are changeable both temporally and spatially, it is important to provide their continual assessment. The aim of the study is to investigate the changes in morphological characteristics in a sample of Serbian 7-year-old children in the period 2005 ­ 2014. The data was gathered from medical documentation recorded in the period 2005-2014 in the local health-care centre "Dr Dusan Savic­ Doda" in Beocin, which is situated in the central part of the province Vojvodina, the north-west part of Serbia. Most of the population consists of Serbs (69.7 %), and the second largest group are Roma (9 %) who came to this region in the 1990s as refugees from Kosovo. The categorization of the participants was based on their decimal age ranging from 6.50 to 7.49 years. Body height and weight were measured, and nutritional status categories were set in relation to the cut off values of body mass index (BMI) of the age of 7 (kg/m2) as proposed by IOTF- International Obesity Task Force. The study has pointed to an increasing trend in height and a decrease of BMI. Analysing the period of ten years, the height, weight and BMI in seven-year-olds living on the territory on Beocin municipality have proven to be slightly lower than in the children of the same age in other parts of Vojvodina and Serbia. The obtained results point to the need of further investigations of children living in this region in order to provide a better insight into the changes of the morphological parameters.

Las características morfológicas de los niños suelen implicar los procesos de crecimiento y desarrollo. La información sobre el crecimiento de los niños en altura y peso corporal se utiliza a menudo como el indicador de su salud y de su estado nutricional. Como los parámetros son cambiantes tanto temporalmente como espacialmente, es importante realizar una evaluación continua. El objetivo del estudio fue investigar los cambios en las características morfológicas en una muestra de niños serbios de 7 años en el período 2005-2014. Los datos se obtuvieron de la documentación médica registrada en el período 2005-2014 en el Centro de Atención de Salud "Dr Dusan Savic - Doda" en Beocin, situado en la region central de la provincia Vojvodina, al Noroeste de Serbia. La mayor parte de la población se compone de serbios (69,7 %) y el segundo grupo más grande son los romaníes (9 %) que llegaron a esta región en la década de 1990 como refugiados de Kosovo. Los participantes fueron clasificados en base a su edad decimal de 6,50 a 7,49 años. Se midió la estatura y el peso corporal y se establecieron las categorías de estado nutricional en relación con los valores de corte del índice de masa corporal (IMC) de 7 años de edad (kg / m2), según lo propuesto por IOTF International Obesity Task Force. El estudio ha señalado una tendencia creciente en altura y una disminución del IMC. Analizando el período de diez años, la altura, el peso y el IMC en niños de siete años que viven en el territorio del municipio de Beocin han demostrado ser ligeramente más bajos que en los niños de la misma edad en otras areas de Vojvodina y Serbia. Los resultados obtenidos apuntan a la necesidad de nuevas investigaciones de los niños que viven en esta región con el fin de proporcionar una mejor visión de los cambios en los parámetros morfológicos.

Analysis of risk factors and clinical manifestations associated with Clostridium difficile disease in Serbian hospitalized patients

Abstract Clostridium difficile is the leading cause of infectious diarrhoea in hospitalized patients. The aim of this study was to determine the risk factors important for the development of hospital-acquired Clostridium difficile-associated disease and clinical manifestations of Clostridium difficile-associated disease. The clinical trial group included 37 hospitalized patients who were selected according to the inclusion criteria. A control group of 74 hospitalized patients was individually matched with cases based on hospital, age (within 4 years), sex and month of admission.Clostridium difficile-associated disease most commonly manifested as diarrhoea (56.76%) and colitis (32%), while in 8.11% of patients, it was diagnosed as pseudomembranous colitis, and in one patient, it was diagnosed as fulminant colitis. Statistically significant associations (p < 0.05) were found with the presence of chronic renal failure, chronic obstructive pulmonary disease, cerebrovascular accident (stroke) and haemodialysis. In this study, it was confirmed that all the groups of antibiotics, except for tetracycline and trimethoprim-sulfamethoxazole, were statistically significant risk factors for Clostridium difficile-associated disease (p < 0.05). However, it was difficult to determine the individual role of antibiotics in the development of Clostridium difficile-associated disease. Univariate logistic regression also found that applying antibiotic therapy, the duration of antibiotic therapy, administration of two or more antibiotics to treat infections, administering laxatives and the total number of days spent in the hospital significantly affected the onset of Clostridium difficile-associated disease (p < 0.05), and associations were confirmed using the multivariate model for the application of antibiotic therapy (p = 0.001), duration of antibiotic treatment (p = 0.01), use of laxatives (p = 0.01) and total number of days spent in the hospital (p = 0.001). In this study of patients with hospital-acquired diarrhoea, several risk factors for the development of Clostridium difficile-associated disease were identified.