Abstract Cancer of the cervix has a progressive character and is one of the most significant public health problems in many countries. Our research aimed to translate EORTC QLQ CX 24 (European Organization for Research and Treatment of Cancer; Quality of life questionnaire-cervical cancer 24) from English to Serbian, to create essential cultural adaptations and to analyze psychometric properties of the translation in a model of female inpatients with cancer of the cervix. The QLQ CX 24 was translated and adapted according to internationally established guidelines, and then tested on a sample of 100 Serbian females with cancer of the cervix. The testing was repeated three times on the same patients. We calculated the internal consistency (Cronbach’s alpha), criterion validity, convergent validity, and discriminative validity of the QLQ CX 24. We used factor analysis to discover the original construct. The Serbian translation of QLQ CX 24 showed good internal consistency, showed satisfactory reliability, and temporal stability. In the first, when was rated by the investigators Cronbach’s alpha was 0.607, and one month later when the questionnaire also was rated by investigators Cronbach’s alpha was 0.696. When the scale was rated by females themselves Cronbach’s alpha was 0.802. Divergent as well as convergent validity tests had good results. The factorial analysis exposed six domains. The Serbian translation of QLQ CX 24 is a trustworthy and appropriate specific instrument for measuring the quality of life in females with cervical cancer.

Abstract Our aim was to explore and summarize available cases of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) suspected to be associated with amoxicillin reported in the literature. Electronic searches were conducted in several databases. Fifty-one publications describing a total of 64 patients who satisfied inclusion criteria were included in the review. The age of the patients ranged from 1.5-80 years (median: 24.5 years). TEN, SJS and SJS/TEN overlap were diagnosed in 30 (46.9%), 28 (43.8%) and 1 (1.6%) patients, respectively. SJS/TEN may occur promptly after administration of amoxicillin, but it could also be a delayed adverse effect. The total length of hospital stay ranged from 3-70 days (median: 16 days). Amoxicillin-induced SJS/TEN is accompanied by frequent occurrence of serious complications, long-term ocular and skin sequelae and high mortality rate. Clinicians should be aware that amoxicillin alone or combined with clavulanic acid can cause SJS/TEN in patients of all ages.

The aim of this study is to provide a more accurate representation of COVID‐19's case fatality rate (CFR) by performing meta‐analyses by continents and income, and by comparing the result with pooled estimates. We used multiple worldwide data sources on COVID‐19 for every country reporting COVID‐19 cases. On the basis of data, we performed random and fixed meta‐analyses for CFR of COVID‐19 by continents and income according to each individual calendar date. CFR was estimated based on the different geographical regions and levels of income using three models: pooled estimates, fixed‐ and random‐model. In Asia, all three types of CFR initially remained approximately between 2.0% and 3.0%. In the case of pooled estimates and the fixed model results, CFR increased to 4.0%, by then gradually decreasing, while in the case of random‐model, CFR remained under 2.0%. Similarly, in Europe, initially, the two types of CFR peaked at 9.0% and 10.0%, respectively. The random‐model results showed an increase near 5.0%. In high‐income countries, pooled estimates and fixed‐model showed gradually increasing trends with a final pooled estimates and random‐model reached about 8.0% and 4.0%, respectively. In middle‐income, the pooled estimates and fixed‐model have gradually increased reaching up to 4.5%. in low‐income countries, CFRs remained similar between 1.5% and 3.0%. Our study emphasizes that COVID‐19 CFR is not a fixed or static value. Rather, it is a dynamic estimate that changes with time, population, socioeconomic factors, and the mitigatory efforts of individual countries.

ABSTRACT Introduction Neuroactive peptides are peptides produced by neurons and released through controlled mechanisms that bind to specific receptors on nerve, glial, or other cell types, causing biochemical response(s) within these cells. Areas covered This article summarizes and interprets recent advancements in our knowledge of neuroactive peptides with pro- or anti-convulsant action, and about new drugs that use the molecular machinery of neuroactive peptides to suppress seizures. Expert opinion According to the results of preclinical and limited clinical investigations to date, the highest potential to become anti-epileptic drugs with marketing authorization belongs to non-peptide agonists of melanocortin receptors, thyrotropin-releasing hormone receptors, ghrelin receptors, galanin receptors, somatostatin and cortistatin receptors, oxytocin receptors, cholecystokinin receptors, and opioid kappa receptors, followed by non-peptide antagonists of the renin-angiotensin system, corticotropin-releasing hormone receptors, NK1 receptors for substance P, arginine-vasopressin receptors, and opioid delta receptors.

OBJECTIVES Our aim was construction and development of a new questionnaire for assessing the quality and diversity of nutrition of pregnant women. MATERIAL AND METHODS This was a cross-sectional study. The novel questionnaire was developed through eight steps according with internationally accepted guidelines for questionnaire development. The questionnaire with 18 questions and answers according to the Likert's scale was created and called Balkan Food Quality and Diversity in Pregnancy Questionnaire-18 (BFQDPQ-18). Reliability testing and factor analysis of BFQDPQ-18 were carried out on a sample of 382 women in the third trimester of pregnancy whose pregnancy control and monitoring were performed at the Clinic for Gynecology and Obstetrics of the Clinical Center in Kragujevac, Serbia. RESULTS The first test of reliability indicated high levels of internal consistency, with the Cronbach's alpha of 0.85 of the BFQDPQ-18. After dividing the BFQDPQ-18 into two parts of nine questions each by split-half method, the Cronbach's alphas were 0.799 and 0.716. The Kaiser-Meyer-Olkin Measure of Sampling Adequacy (KMO) was 0.878, and the Bartlett's test of sphericity: 1,892.206, p < 0.000. Factor analysis revealed four factors explained in total 51.99% of the variance: mean meal and snack, foods with a low degree of industrial processing, subjective assessment of dietary quality and starchy foods. CONCLUSIONS The final version of the BFQDPQ-18 showed high reliability and good psychometric properties, so we believe it could be useful instrument for assessing the quality of nutrition of pregnant women.

Abstract Background. Symptoms of depression are often present in patients with chronic obstructive pulmonary disease (COPD) and treatment of depression may substantially improve the quality of life of such patients. The aim of our study was to investigate factors that influence the efficacy of antidepressant therapy in terms of the quality of life in patients with COPD and a depressive disorder. Materials and Methods. The study was designed as a prospective cross-sectional study and conducted between October 2016 and December 2019 in the Primary Health Center, Kragujevac, Serbia. The study sample included 87 patients. Associations between putative risk factors and change in the quality-of-life score were tested by a multivariate linear regression model and interpreted by the regression coefficients. Results. Our study showed a clear positive effect of therapy with SSRIs on the severity of depression symptoms and the quality of life of patients with co-occurrence of COPD and depression. However, multiple linear regression shows that the effect of SSRIs was more prominent in patients with a higher degree of COPD severity since patients with lower FEV1 values had a more extensive increase in the Q-LES-Q-SF score (B=-0,034; p=0,020). Conclusion. Treatment of depression that accompanies COPD is an important segment of managing such patients, which significantly improves HRQoL. Patients with more severe COPD would especially benefit from such treatment since their response to SSRIs is more pronounced.

Our aim was to determine the prevalence of potential drug-drug interactions (pDDIs) and to identify relevant factors associated with the occurrence of the most dangerous or contraindicated pDDIs (pCDDIs) in hospitalized patients with spontaneous intracerebral hemorrhage (sICH). A retrospective cross-sectional study was performed enrolling all consecutive patients with sICH treated at the Neurological Intensive Care Unit, Clinical Center in Kragujevac, Serbia, during the three-year period (2012-2014). The inclusion criteria encompassed patients aged 18 years and over, those diagnosed with ICH, and those prescribed at least two drugs during hospitalization, while we did not include patients whose hospitalization lasted less than 7 days, those who were diagnosed with other neurological diseases and patients with incomplete medical files. For each day of hospitalization, the online checker Micromedex® software was used to identify pDDIs and classify them according to severity. A total of 110 participants were analysed. A high prevalence of pDDIs (98.2%) was observed. The median number of pDDIs regardless of severity, was 8.00 (IQR 4.75-13.00;1-30). The pairs of drugs involving cardiovascular medicines were the most commonly identified pDDIs. Twenty percent of the total number of participants was exposed to pCDDIs. The use of multiple drugs from different pharmacological-chemical subgroups and the prescribing of anticoagulant therapy significantly increase the chance of pCDDI (aOR with 95% CI 1.19 (1.05-1.35) and 7.40 (1.13-48.96), respectively). This study indicates a high prevalence of pDDIs and pCDDIs in patients with sICH. The use of anticoagulant therapy appears to be the only modifiable clinically relevant predictor of pCDDIs.

Abstract Introduction Professional drivers’ knowledge about driving-impairing medications is not satisfactory. The aim of this study was to develop and test the reliability and validity of the questionnaires designed to measure the knowledge and attitude of professional drivers about the influence of various medications on driving ability. Methods The questionnaires for assessing professional driver’s knowledge (performance-based) and attitudes about influence of various medications on driving abilities were developed by creating the item pool, testing reliability and validity, and factor analysis. The study was conducted as a multicenter, cross-sectional study in Serbia and Bosnia and Herzegovina. The study population consisted of professional drivers, who filled out both questionnaires in three time intervals. Results Both questionnaires showed great internal consistency and temporal stability. Cronbach’s Alpha for the first questionnaire was 0.984 and for the second it was 0.944. The Kaiser–Meyer–Olkin test for the first questionnaire confirmed sampling adequacy with its value of 0.964 and for the second questionnaire it was 0.933. Exploratory factor analysis of the questionnaire showed that three factors were revealed after rotation for the first questionnaire and they explained 78.0% of variance. Both questionnaires showed high degree of correlation between scores after the first and repeated administration, Spearman’s rho coefficient of correlation for was 0.962 and 0.980. Conclusion Based on the results of this study, we believe that both questionnaires are useful tools for testing professional drivers’ knowledge and attitudes about the influence of medications on driving ability.

Abstract Rare diseases (RD) are serious chronic diseases affecting small number of people compared to the general population. There are between 6000 and 8000 RDs, which affect about 400 million people worldwide. Drugs used for causal treatment of RDs are called orphan drugs. RDs bear great clinical and economic burden for patients, their families, healthcare systems and society overall. There are at least two reasons for the high cost of treatment of RDs. First, there is no causal therapy for majority of RDs, so exacerbations, complications, and hospitalizations in those patients are common. The second reason is high price of available orphan drugs, which are not cost-effective when traditional pharmacoeconomic evaluation is employed. The pharmacoeconomic aspect of the treatment of RDs is especially important in the field of neurology, since at least one fifth of all RDs is composed of neurological conditions. The aim of this paper was to provide a concise overview of the pathophysiological, epidemiological and clinical characteristics of some of the most important and common rare neurological diseases, with special reference to their impact on society and economy.

It is very well known that science is world activity and that there is no good and bad work in the field of scientific research. Nowadays scientific productivity of the individuals, learned societies on regional or state level are measurable parameters. In most of the systems it does include the number of original scientifi papers, quality of journals measured by impact factor and scientific citation index (1-4). There are also additional measurable parameters but for the purpose of this meeting we will avoid discussion about them. New field of scientometrics using the help of impartial and ruthless machines (computers) do help very significantly in evaluation of scientific productivity anywhere in the world. Unfortunately, there are many misused conclusions and interpretation on the data offered by computers. It is clear that some vital important changes are urgently needed. Today’s conference should use rare opportunity having together experts in the field to discuss the problems visible now. This author intends to discuss facts and doubts in writing review articles and chapters in the book (5). Some important flexibility in citation, in particular self citation, should be analyzed. An illustrative examples from author’s own experience will be shown and discussed at the meeting.

Abstract Background Translations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults. Methods The study was of a cross-sectional type, assessing the reliability and validity of a newly developed questionnaire for measuring health-related quality of life (HRQoL) in adults residing in western Balkan states (WB-HRQoL). It was conducted on a sample of 489 adults from Serbia, Croatia, Bosnia & Herzegovina, and Montenegro, with a mean age of 52.2±14.4 years and a male/female ratio of 195/294 (39.9%/60.1%). Result The definitive version of the WB-HRQoL scale with 19 items showed very good reliability, with Cronbach’s alpha 0.905. The scale was temporally stable, and satisfactory results were obtained for divergent and convergent validity tests. Exploratory factorial analysis brought to the surface four domains of health-related quality of life, namely the physical, psychical, social, and environmental. Conclusion The WB-HRQoL scale is a reliable and valid generic instrument for measuring HRQoL that takes into account the cultural specifics of the western Balkan region.

ABSTRACT Introduction Disease-specific treatments are available only for a minority of patients with genetic epilepsies, while the rest are treated with anticonvulsants, which are ineffective in almost one-third of patients. Areas covered Recently approved and the most effective emerging therapeutics under development for the treatment of genetic epilepsies are overviewed after systematic search and analysis of relevant literature. Expert opinion New and emerging drugs for genetic epilepsies exploit one of the two approaches: inhibiting hyperactive brain foci through blocking excitatory or augmenting inhibitory neurotransmission, or correcting the underlying genetic defect. The first is limited by insufficient selectivity of available compounds, and the second by imperfection of currently used vectors of genetic material, unselective and transient transgene expression. Besides, the treatment may come too late, after structural abnormalities and epilepsy deterioration takes place. However, with recent improvements, we can expect to see soon gradual decline in the number of patients with therapy-resistant genetic epilepsies.

Background and Objectives: Although vitamin D insufficiency or deficiency is prevalent in children with allergic diseases, recommendations for supplementation dosing regimens are imprecise and variable in the literature, because clinical trials aiming to determine optimal doses were scarce in the past. This study aimed to investigate supplementation of vitamin D3 that may achieve therapeutically effective but not toxic serum levels in a subpopulation of children with allergic diseases and concomitant hypovitaminosis D. Materials and Methods: The retrospective, observational study with a cross-sectional design included 94 children suffering from allergic diseases and having vitamin D deficiency/insufficiency who were prescribed high-dose vitamin D3 supplementation by a pediatrician for at least 6 weeks and not more than 9 weeks. Serum levels of the major metabolite of vitamin D (25-(OH)D) were determined in all children twice: before and two weeks after the end of vitamin D3 supplementation. Results: An increase in serum level of the 25-(OH)D after supplementation was significant. However, if the subjects had higher serum levels of the 25-(OH)D before the supplementation, and if the supplementation lasted 8 instead of 6 weeks, the absolute increase in serum level of the 25-(OH)D was lower. Patients taking corticosteroids as inhalation or intranasally had a more intense effect of vitamin D3 supplementation, i.e., the absolute increase in levels of 25-(OH)D was higher than in patients not using such medication. Conclusions: Vitamin D deficiency and insufficiency in children with allergic diseases can be treated with maximal recommended doses of vitamin D3 for a short period of time, especially if they were prescribed with inhalation or intranasal corticosteroids.