People have traveled for a long time to various destinations to use medical services that in the period of health tourism were related to disease prevention, rehabilitation, but also treatment with ...the help of natural factors. In the second half of the 20th and the beginning of the 21st century, health tourism went beyond the initial framework through a qualitative and quantitative change in the tourist offer. An important resource basis for health tourism is the spa places where appropriate health resorts have been built. The Republic of Serbia is known for its very rich and diverse offer of spa destinations. The study, without the intention to determine a standardized definition of the term, presents various aspects of health tourism and a brief analysis of the development of spa tourism in Serbia. The subject of this paper is the SWOT analysis of the health and tourism center Rajska Banja, with an emphasis on the possibilities of tourism development in the municipality of Zvecan. The aim of the paper is to point out through the valorization of the spa potential in Kosovo and Metohija that health tourism in this area needs a new development concept in accordance with modern trends in the tourist market, in the function of strengthening the tourist offer. The limitations of the research were presented and recommendations for improving the tourist offer of the north of Kosovo and Metohija were given.
Good interpersonal cooperation is necessary for the efficient and effective work of any organization, institution, program, project or team. Conflicts are an inevitable companion of good ...interpersonal relations and cooperation. Effective resolution of conflicts within any organization, including healthcare organizations, should be a priority due to their direct impact on the quality of healthcare provided. The paper aims to examine the influence of interpersonal health workers on the effectiveness of the health institutions where they are employed. The paper examines whether employees in a healthcare facility are exposed to conflict situations, as well as whether there is a connection between conflicts such as negative interpersonal relationships and business efficiency, i.e., the provision of healthcare services. Furthermore, the paper examines the differences between the conflict and the sociodemographic characteristics of the respondents. The research was conducted in the Healthcare center in Zvečan (Kosovska Mitrovica) through a survey. The research sample (N=103) consisted of employees in the aforementioned health institution.
Osteoarthritis (OA) is a progressive degenerative disease with an inflammatory background. Chronic myeloproliferative neoplasms (MPN) are clonal hematopoietic disorders characterized by chronic ...inflammation and a tendency for connective tissue remodeling.
This study aimed to investigate the prevalence and associated risk factors of symptomatic OA (sOA) in MPN patients.
A total of 100 consecutive MPN (39 essential-thrombocythemia, 34 polycythemia-vera, 27 myelofibrosis) patients treated in two community hematologic centers were cross-sectionally evaluated. Patients were required to have both symptoms attributable to hip and/or knee OA and radiographic confirmation to be considered as having sOA.
The prevalence of hip and/or knee sOA was significantly higher among MPN patients than the previously reported prevalence in the general population of similar age (61% vs. 22%,
< 0.001). Hip sOA was present in 50%, knee sOA in 51% and sOA of both localizations in 41% of patients. A high proportion of MPN patients had radiographic signs of hip OA (94%) and knee OA (98%) in the presence of attributable symptoms. Among the other factors, sOA was univariately associated with the presence of
mutation, myelofibrosis phenotype, older age, higher body weight, and higher MPN-SAF score (
< 0.050 for all analyses). In the multivariate analysis, older age (odds ratio = 1.19, 95% confidence interval-CI 1.06-1.33) and higher body weight (OR = 1.15, 95% CI 1.06-1.25) were recognized as independent risk factors for sOA. On the other hand, cytoreductive treatment was a protective factor for sOA (OR = 0.07, 95% CI 0.006-0.86).
The prevalence of sOA in MPN patients was higher than that in the general population and seems to correlate with older age, increased myeloproliferation and a higher inflammatory state. Whether cytoreductive treatment may postpone OA development in MPN patients warrants additional confirmation.
Here, we present possible death caused by Mycobacterium gordonae infection in a patient with angioimmunoblastic T-cell lymphoma. Our patient was severely immunocompromised in whom we suspect to an ...infection, but we did not have isolates until she died. After she died, we received a positive sputum culture of M. gordonae. We conclude that when having severely immunocompromised patients with suspicion of infection but without isolates we should always consider the saprophytic mycobacteria. These mycobacteria require a long period of isolation, but patients with these mycobacteria are potentially curable if appropriate treatment is applied for a sufficiently long period.
Primary cutaneus apocrine carcinoma is a rare malignancy with about 50 cases reported in the literature. Axilla is the most common site of occurrence, but locations like scalp, anogenital region, ear ...canal, chest, wrist, finger and eyelid have been described. The neoplasm presents itself as an asymptomatic, slow-growing, solid or cystic mass that varies in color. Most patients have a history of a long-standing neoplasm before the diagnosis is made. The disease is considered to have an indolent clinical course with favorable outcome although more than half of reported patients had regional lymph node metastases at the time of diagnosis. Systemic dissemination to lung, bones, liver and brain is extremely rare with only 14 cases documented in the literature. Wide surgical excision with lymph node dissection upon confirmation of the lymph node metastases remains the only curable treatment. Care and management of the disseminated disease is still challenging. We report a case of a 65-year-old woman with a very aggressive apocrine carcinoma of the scalp prone to local recurrence and distant metastases to lung and bones.
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