Physical activity before and during the COVID-19 pandemic in Vojvodina, Serbia.

Background: The physical activity (PA) of the youth and adult population underwent changes during the last 2 years due to the coronavirus (COVID-19) pandemic, and all for the purpose of maintaining the health of the population. The purpose of this study was to estimate the levels of PA in the youth population and the adult population (young and old) during the COVID-19 pandemic in the territory of Vojvodina, Serbia, and to determine the differences between them, as well as to compare these results with the results before the pandemic. Methods: A total of 1,117 subjects (age 36.27 ± 15.08 years) from the territory of Vojvodina, Serbia, participated in the study. Subjects were recruited and assigned to one of the three groups according to their age: youth group (N = 395; age 18-24 years), young adults group (N = 347; from 25 to 44 years), and old adults group (N = 375; age 45-65 years). All participants in this study completed the International Physical Activity Questionnaire Short-Form between July and November 2021, during the fourth wave of the COVID-19 pandemic in Vojvodina, Serbia. The Kruskal-Wallis test and Dunn multiple comparison post-hoc method were used for statistical analyses. Results: The youth showed the highest result in total weekly energy expenditure (3,893.72 ± 2,010.01 MET-min/week) compared to young adults (2,528.20 ± 1,804.11 MET-min/week) and old adults (2,369.07 ± 2,084.95 MET-min/week) during the COVID-19 pandemic in Vojvodina, Serbia. In addition, adults (young and old) spent more time sitting than youth during the same period. Furthermore, the youth achieved greater results in levels of PA during the COVID-19 pandemic compared to the situation before the COVID-19 pandemic. However, adult populations achieved lower results during the COVID-19 pandemic than before the COVID-19 pandemic. Conclusion: During the COVID-19 pandemic, the youth from Vojovida, Serbia, achieved greater results in PA levels than the adult populations. Based on that, we recommend that it is necessary to take steps toward increasing PA in the adult population, especially old adults.

Clinical Presentations, Predictive Factors, and Outcomes of Clostridioides difficile Infection among COVID-19 Hospitalized Patients-A Single Center Experience from the COVID Hospital of the University Clinical Center of Vojvodina, Serbia.

Background: This study aimed to investigate the clinical form, risk factors, and outcomes of patients with COVID-19 and Clostridioides difficile co-infections. Methods: This retrospective study (2 September 2021-1 April 2022) included all patients with Clostridioides difficile infection (CDI) and COVID-19 infection who were admitted to the Covid Hospital of the University Clinical Center of Vojvodina. Results: A total of 5124 COVID-19 patients were admitted to the Covid Hospital, and 326 of them (6.36%) developed hospital-onset CDI. Of those, 326 of the CDI patients (88.65%) were older than 65 years. The median time of CDI onset was 12.88 days. Previous hospitalizations showed 69.93% of CDI patients compared to 38.81% in the non-CDI group (p = 0.029). The concomitant antibiotics exposure was higher among the CDI group versus the non-CDI group (88.65% vs. 68.42%, p = 0.037). Albumin levels were ≤ 25 g/L among 39.57% of the CDI patients and 21.71% in the non-CDI patients (p = 0.021). The clinical manifestations of CDI ranged from mild diarrhea (26.9%) to severe diarrhea (63.49%) and a complicated form of colitis (9.81%). Regarding outcomes, 79.14% of the CDI patients recovered and 20.86% had fatal outcomes in-hospital. Although a minority of the patients were in the non-CDI group, the difference in mortality rate between the CDI and non-CDI group was not statistically significant (20.86% vs. 15.13%, p = 0.097). Conclusions: Elderly patients on concomitant antibiotic treatments with hypoalbuminemia and with previous healthcare exposures were the most affected by COVID-19 and CD co-infections.

Incidence of Type 1 Diabetes Mellitus and Characteristics of Diabetic Ketoacidosis in Children and Adolescents during the First Two Years of the COVID-19 Pandemic in Vojvodina.

Background and Objectives: The COVID-19 pandemic has led to significant changes globally, which has also affected patients with type 1 diabetes mellitus (T1DM). This study aimed to determine the incidence of T1DM and the characteristics of diabetic ketoacidosis (DKA) during the pandemic comparing it to pre-pandemic period. Materials and Methods: Data from patients <19 years with newly diagnosed T1DM between 1st January 2017 and 31st December 2021 from four regional centers in Vojvodina were retrospectively collected and analyzed. Results: In 2021, the highest incidence of T1DM in the last five years was recorded, 17.3/100,000. During the pandemic period (2020-2021), there were 99 new-onset T1DM, of which 42.4% presented in DKA, which is significantly higher than in the pre-pandemic period (34.1%). During the pandemic, symptom duration of T1DM lasted significantly longer than before the COVID-19 period. At the age of 10-14 years, the highest incidence of T1DM and COVID-19, the highest frequency rate of DKA, and severe DKA were observed. Conclusions: The pandemic is associated with a high incidence rate of T1DM, longer duration of symptoms of T1DM, a high frequency of DKA, and a severe DKA at diagnosis. Patients aged 10-14 years are a risk group for the occurrence of T1DM with severe clinical presentation. Additional studies are needed with a longer study period and in a wider geographical area, with data on exposure to COVID-19 infection, the permanence of new-onset T1DM, and the psychosocial impact of the pandemic.

Historical review: Towards the 50th anniversary of the last major smallpox outbreak (Yugoslavia, 1972).

In 1972, Yugoslavia experienced the largest outbreak of smallpox in the history of Europe following the Second World War and its first smallpox outbreak after 1930. The origin of the infection is believed to be a pilgrim who visited countries in the Middle East. In this epidemic in Yugoslavia, from 16th February to 11th April 1972, a total of 175 people fell ill, 35 (20%) of whom died. Measures against the outbreak were based on the strategy that was common in the final phase of the smallpox eradication program. It started with active surveillance and rapid identification of new cases. Measures, such as mass vaccination and quarantine of direct contacts, were promptly taken. In a few weeks, 18 million people had been vaccinated and approximately 15,000 had been quarantined. Yugoslavia was declared free of smallpox on 9th May 1972. The global community today is confronted with serious threats from infectious diseases, which can appear as outbreaks and pandemics.

Performance evaluation of general public hospitals in territories of the Former Yugoslavia: An ecological study using the Pabon Lasso model.

BACKGROUND: Measuring hospital performance is an area of great importance due to limited resources. Additionally, hospital activities are vital during emergencies providing care under pressure of external factors. AIM: This study aimed at analysing performances of general public hospitals from territories of the Former Yugoslavia. METHOD: This ecological study includes 99 hospitals from 6 territories based on annual reports of institutions in charge of territorial health data. The Pabon Lasso method was used, considering hospitals in the third quadrant of the plot as top-performing in the territory. A particular focus was on performance changes during the pandemic caused by SARS-COV-2 coronavirus. RESULTS AND CONCLUSION: There is considerable heterogeneity in the length of stay, bed occupancy and turnover rate between territories. The proportion of top-performing hospitals varied between 20% and 43%, providing between 16% and 69% of inpatients episodes within the territory. However, countries did not differ in how their hospitals were distributed across the four quadrants of the Pabon Lasso plot. Comparison of Croatian and Kosovar data from 2019 to 2020 suggested a significant decrease in turnover and occupancy rates, but most hospitals retained their plot quartiles from the previous year. This supports the finding that there were no significant changes in hospital performance based on the Pabon Lasso method. The analysis showed significant room for performance improvement and highlighted the ability of the Croatian and Kosovar hospitals and their health systems to maintain efficiency during emergencies.