Peptide receptor radionuclide therapy (PRRT) is a treatment option for well-differentiated, somatostatin receptor positive, unresectable or/and metastatic neuroendocrine tumors (NETs). Although high ...disease control rates seen with PRRT a significant number NET patients have a short progression-free interval, and currently, there is a deficiency of effective biomarkers to pre-identify these patients. This study is aimed at determining the prognostic significance of biomarkers on survival of patients with NETs in initial PRRT treatment.
We retrospectively analyzed 51 patients with NETs treated with PRRT at the Department for nuclear medicine, University Clinical Center Kragujevac, Serbia, with a five-year follow-up. Eligible patients with confirmed inoperable NETs, were retrospectively evaluated hematological, blood-based inflammatory markers, biochemical markers and clinical characteristics on disease progression. In accordance with the progression og the disease, the patients were divided into two groups: progression group (n=18) and a non-progression group (n=33). Clinical data were compared between the two groups.
A total of 51 patients (Md=60, age 25-75 years) were treated with PRRT, of whom 29 (56.86%) demonstrated stable disease, 4 (7.84%) demonstrated a partial response, and 14 (27.46%) demonstrated progressive disease and death was recorded in 4 (7.84%) patients. The mean PFS was a 36.22 months (95% CI 30.14-42.29) and the mean OS was 44.68 months (95% CI 37.40-51.97). Univariate logistic regression analysis displayed that age (p<0.05), functional tumors (p<0.05), absolute neutrophil count (p<0.05), neutrophil-lymphocyte ratio-NLR (p<0.05), C-reactive protein-CRP (p<0.05), CRP/Albumin (p<0.05), alanine aminotransferase-ALT (p<0.05), were risk factors for disease progression. Multivariate logistic regression analysis exhibited that functional tumors (p<0.001), age (p<0.05), CRP (p<0.05), and ALT (p<0.05), were independent risk factors for the disease progression in patients with NETs. Tumor functionality was the most powerful prognostic factor. The median PFS (11.86 ± 1.41 vs. 43.38 ± 3.16 months; p=0.001) and OS (21.81 ± 2.70 vs 53.86 ± 3.70, p=0.001) were significantly shorter in patients with functional than non-functional NETs respectively.
The study's results suggest that tumor functionality, and certain biomarkers may serve as prognostic survival indicators for patients with NETs undergoing PRRT. The findings can potentially help to identify patients who are at higher risk of disease progression and tailor treatment strategies accordingly.
The aim of this study was to investigate how sociodemographic and health factors contribute cognitive abilities in the older population of the Republic of Serbia, using data from the 2019 national ...health survey. The study included 3,743 participants, of whom 2,061 (55.1%) were women and 1,682 (44.9%) were men. The median age of all participants was 72 (10) years. Study used logistic regression on cross-sectional data to analyze how education, social support, and healthcare access affect cognitive abilities, while adjusting for demographic variables. The results revealed negative associations between higher levels of education and lower odds of experiencing memory and concentration problems, while recent visits to specialists were positively associated with increased risk for the same. The highest percentage of participants (22.6%) reporting major difficulties in memory and concentration were in the age group of 85–89 years ( p < 0.001). A statistically significant relationship was found between social support and issues related to memory and concentration ( p < 0.001). Social support emerged as a significant factor in preserving cognitive abilities. The discussion underscores the need for a comprehensive approach in promoting cognitive health, taking into account education, social integration, and access to healthcare as key factors. The study acknowledges its limitations, including its cross-sectional nature and potential subjective biases in self-assessment of cognitive abilities. Future research should incorporate longitudinal studies and more objective measures of cognitive abilities.
Effective reduction of cervical cancer incidence and mortality requires strategic measures encompassing the implementation of a cost-effective screening technology. Serbia has made significant ...strides, introducing organized cervical cancer screening in 2012. However, various impediments to screening implementation persist. The aim of the study was to estimate the socioeconomic factors associated with cervical cancer screening among women in Serbia.
Data from 2019 National Health Survey of the population of Serbia were used in this study. The study is cross sectional survey on a representative sample of the population of Serbia. Present total number of participants analyzed in survey 6,747.
In Serbia, 67.2% of women have done a Pap test at any time during their lives, of which 46.1% of women have undergone cervical cancer screening in the past 3 years. About a quarter of women have never undergone a Pap test in their life (24.3%). The probability of never having a Pap test have: the youngest age group (15-24 years) is 1.3 times more likely than the oldest age group (OR = 1.31), unmarried women 0.3 times more often than married women (OR = 0.37), respondents with basic education 0.9 times more often than married women (OR = 0.98), the women of lower socioeconomic status 0.5 times more often than respondents of high socioeconomic status (OR = 0.56).
Enhancement of the existing CCS would be the appropriate public health approach to decrease the incidence and mortality of cervical cancer in the Republic of Serbia.
Background: The COVID-19 pandemic has had a significant impact on the global economy and public health, disrupting various aspects of daily life. Apart from its direct effects on physical health, it ...has also significantly affected the overall quality of life and mental health. This study employed a path analysis to explore the complex association among multiple factors associated with quality of life, anxiety, and depression in the general population of the Republic of Srpska during the pandemic’s second year. Method: A cross-sectional study was conducted on a nationally representative sample (n = 1382) of the general population (adults aged 20+) during the second year of the COVID-19 pandemic in the Republic of Srpska, Bosnia, and Herzegovina. Assessment tools included the DASS-21 scale for depression, anxiety, and stress, along with the Brief COPE scale, Quality of Life Scale (QOLS), and Oslo Social Support Scale (OSSS-3). Sociodemographic factors and comorbidities were also assessed. Structural equation modeling was used to identify the direct and indirect links of various characteristics to quality of life, anxiety, and depression. Results: This study revealed a considerable prevalence of anxiety and depression symptoms (27.5% and 20.9%, respectively), with quality of life playing a significant mediating role. The constructed path model accounted for 33.1% of moderate to severe depression and 79.5% of anxiety. Negative coping was directly linked to anxiety and indirectly to depression via anxiety, while the absence of positive coping had both direct and indirect paths (through quality of life) on depression. Among variables that directly affected depression, anxiety had the highest effect. However, the bidirectional paths between anxiety and depression were also suggested by the model. Conclusions: Pandemic response strategies should be modified to effectively reduce the adverse effects on public mental health. Further research is necessary to assess the long-term effects of the pandemic on mental health and to analyze the contributing factors of anxiety and depression in the post-COVID period.
Background/Aim. Coagulation disorders could be a cause of menorrhagia in women of reproductive age. The aim of the study was to estimate frequency of coagulation disorders and design an appropriate ...algorithm for detection of coagulation disorders. Methods. We investigated coagulation in 115 women (36.1 ? 9.6 years) with anamnestic data of menorrhagia, verified using semiquantitative method ? Pictorial Bleeding Assessment Chart (PBAC) with score ? 100. Results. Menorrhagia was objectively verified in sixty-four women (55.7%) and in comparison with those with normal menstruation they had higher PBAC score of menstrual cycle median (Md) = 150.0 vs. Md = 50.0; p < 0.001 but not its duration (7.2 ? 2.1 days vs. 7.3 ? 1.9 days; p > 0.05). Coagulation defects was found in 12 (10.4%) women ? decreased F IX: Ac in 4 (3.5%), decreased F VII: Ac in 1 (0.9%), decreased F X: Ac in 1 (0.9%), decreased F XI: Ac in 1 woman (0.9%), while 5 (4.3%) women matched criteria for mild von Willebrand disease (VWD) type 1. Women with coagulation disorders had prolonged prothrombin time (PT) Md = 13.1 s, range: 12.2?14.8 s vs. Md = 12.5 s, range 10.6?18.3 s; p = 0.032. Anemia was diagnosed in 61 (53.0%) women. The strongest predictor of the hemostasis disorder was menorrhagia (Quotient of probability 0.018), then anemia presence (12.43), P? (2.35), menstrual cycle duration (1.16) and the PBAC score (0.98). Conclusion. The results of the study indicate the need to form a diagnostic algorithm for hemostasis disorders, primarily VWD. Sophisticated analysis of hemostasis is required, especially if predictive factors of statistical models are detected: objectively verified menorrhagia, anemia, prolonged menstrual cycle, PBAC score > 100 and extended PT.
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Background/Aim. Depression is the most prevalent mental disorder which affects approximately 7% of the world?s older population. This study aimed at examining the prevalence of depression among older ...adults and its relations to chronic illnesses. Methods. Study was con-ducted within the National Health Survey of the Serbian population in 2013. The questionnaires used as instruments in this study were created in accordance with the questionnaires of the European Health Interview Survey ? Second Wave. The Patient Health Questionnaire-8 (PHQ-8) was used to evaluate the presence of depressive symptoms. The relations between depression symptoms (a de-pendent variable) and a set of independent variables were examined with univariate and multivariate logistic regression analyses. Results. The study showed that there was a 10.0% prevalence of depression within this population with statistically significant differences between the genders ? 12.6% of women and 6.5% of men. The multivariate analysis revealed that multimorbidity odds ratio (OR) = 1.89, chronic pain (OR = 2.35) and self-evaluations of poor health (OR = 8.37) were strongly associated to depression. In terms of individual chronic illnesses, the study showed that strokes double the odds of developing depression (OR = 1.82) while the deformities of lower spine increased this odds by 27%. Conclusion. Depression is very frequent in older persons who suffer from chronic diseases and medical conditions. It is crucial to enable ad-equate screening in primary healthcare institutions in order to diagnose depression in its early stages and start its treatment as soon as possible.
Introduction/Aim. Reproductive health and cervical cancer screeaning are public health priorities. The aim of the study was to asses the sexual behavior and prevalence of cervical cancer screening ...use in the Šumadija District, Serbia. Methods. The research was conducted as a cross-sectional study. The study population consisted of 510 females aged 18 -49 years, living on the territory of the Šumadija District. An anonymous standardised questionnaire was used as a research tool based on the research protocol entitled "The World Health organization, STEPwise Approach to Noncommunicable Disease Risk Factor Surveillance (STEPS)". Results. During the first sexual intercourse, 60.1% of the surveyed population used some of the contraceptives, whereas during the last sexual intercourse, 72.5% of the female respondents reported not having used any of these. Out of the total number of female respondents, every fifth respondent reported not having had a single Pap smear in her lifetime performed (22.8%), i. e. 85.0% of the female respondents aged 19 -29 years (p < 0.001), every third female respondent who had completed elementary school (28.4%) p = 0.009, and every third respondent who was not married (33.3%) (p = 0.01). Conclusion. All the activities should be directed towards increasing the levels of accessibility and availability of the institutions and cervical cancer screening services provided there. In addition, resource capacities should be enhanced as well (medical staff, rooms, equipment).
Social support as a complex construct has a positive influence not only on a patient's condition but also on the process of the patient's emotional adjustment to cancer. The goal of this study is to ...investigate aspects of the level of social support in oncology patients and its interconnection with sociodemographic and medical variables.
The study was conducted as a prospective observational study in 2020, including 250 patients aged 19 and over, both sexes, with a diagnosis of oncological disease. The research was conducted in the Department of General Medicine of the Health Center Trstenik, Central Serbia, after approval by the Ethics Committee of the Health Center Trstenik, Central Serbia. A social support assessment questionnaire (Oslo-3 Social Support Scale) was used as a research instrument.
Data collected from the entire study population showed that bad social support was present in almost 90% of cases. Univariate and multivariate regression analysis showed a statistically significant influence of the following variables on the bad social support: education level, activity limitation, difficulties in performing daily activities, the impact of pain on the performance of activities, the need for additional help with activity, the need for help at home, unfulfilled needs for health care, means of information, anxiety score and depression score.
Interventions to increase social support may be important for enhancing mental health and quality of life in cancer patients.
Background/Aim. Depression and anxiety problems are a major public health concern due to their high prevalence rates, difficult treatment, and often chronic course. This study examined the impact of ...somatic symptoms on depressive and anxiety symptoms among university students in Serbia. Methods. A cross-sectional study was performed among 1,940 students using a questionnaire specially designed for this study which included presence of Somatic and Non-specific Mental Symptoms (SNMS), Beck Depression Inventory and Beck Anxiety Inventory. The presence of somatic and associated non-specific mental symptoms over the last six months served as the basis for creating a new variable called SNMS score. Results. Receiver operating characteristic (ROC) curve showed that the SNMS score might be a very good marker for the distinction of students with or without depressive symptoms (area = 0.754, p < 0.05). The threshold value was 8.50 (sensitivity 67.6%, specificity 69.4%). Binary logistic regression showed that Odds ratio was 1.052 95% confidence interval (CI) 1.045?1.059, which means that an increase in the value of the SNMS score by 1 increases the risk of depressive symptoms by 5.2%. ROC curve showed that the SNMS score might be an excellent marker for the distinction of students with or without anxiety symptoms (area = 0.800, p < 0.05). Limit value (cut-off) was 7.50 (sensitivity 74.2%, specificity 71.6%). Binary logistic regression showed that odds ratio was 1.056 (95% CI 1.049?1.064), which means that increasing the value of SNMS score by 1 increases the risk of anxiety symptoms by 5.6%. Conclusion. The SNMS score might be a state marker for the screening and distinction of students with depressive symptoms, and excellent state marker for screening and making distinction between students with anxiety symptoms and the students who do not have these symptoms.
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