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L. Pecchia, P. Bath, N. Pendleton, M. Bracale

Falls occur frequently among older people and represent the most common cause of injury-related morbidity and mortality in later life. Preventing falls is an important way to reduce injuries, hospitalizations, and injury-related morbidity and mortality among older people. The research literature has identified hundreds of risk factors for falls among elderly people. Prioritizing risk factors for falls is useful for designing effective and efficacious prevention programs. The aim of this study was to use the Analytic Hierarchy Process to develop a hierarchy of risk factors for falls based on the knowledge and experience of experts working in this field.

M. Čuk, S. Ušaj, I. Klem, R. Gajanin, Danijela Batinić Škipina, R. Marić, S. Marić, Nenad Lalović et al.

<p><strong>Introduction.</strong> Extramural venous invasion (EMVI) is a significant predictive factor of the prognosis for patients with colorectal carcinoma and it is directly connected with the relapse of a disease, especially with the appearance of distant metastases. <strong>Methods.</strong> The research comprises 90 patients with colorectal cancer. Representative samples of tumor tissues obtained by surgical resection are fixed in 4% formalin and embedded into paraffin blocks. Semi-series incisions of 4&mu;m thickness were stained by HE method and Van Gieson&rsquo;s method. <strong>Results. </strong>Out of 90 analyzed patients, 21 (23,33%) were with EMVI, and 69 (76.67%) without EMVI on the histological preparations stained by HE method. EMVI was found in 7 more tumors on the preparations stained by Van Gieson&rsquo;s method. Sensitivity of the method determining EMVI on the histological preparations stained by Van Gieson&rsquo;s method was better for 25% (7/28) than on the preparations stained by HE method. EMVI was not found in patients at A and B1 stage of disease according to Astler- Coller classification, but out of 77 patients which were at B2, C1 and C2 stage EMVI was found in 28 (36,36%) patients, p&le;0,01. EMVI was found in 18/77 (23,38%) patients who had a tumor of low histological gradus, p&le;0,01 and in 10/13 (76,92%) patients who had a tumor of high histological gradus, p&le;0,01. In patients with neural invasion, EMVI was found in 18/22 (81,82%), whereas in patients without neural invasion EMVI was found in 10/68 (14,71%), p&le;0,01. In patients with weak intensity of peritumoral lymphocytic reaction EMVI was found in 20/41 (48,78%) whereas in patients with moderate and noticeable level it was found in 8/49 (16,33%), p&le;0,01. There was a significant correlation between extramural venous invasion and other parameters of unfavorable prognosis. <strong>Conclusion.</strong> EMVI is an important indicator in administration of postoperative adjuvant therapy in patients with colorectal carcinoma. A special histochemical method of elastic fiber stain should be applied in everyday practice when EMVI is not found on HE stained preparations in patients with CRC.</p>

M. Joksović, G. Bogdanovic, V. Kojić, K. M. Szécsényi, V. Leovac, D. Jakimov, S. Trifunović, Violeta Marković et al.

S. Medenica, M. Stojaković, B. Zrnić, G. Vasić, V. Prodanović, Helena Marić

<p>Holistic approach to the nature of human beings shows the view of the man as a unique and indivisible whole and not as a collection of organs that are not interconnected. This means the integrity of the biological, psychological and social nature of the man and that just means the psychosomatic approach to the disease. More and more studies indicate that psychological stress can aggravate or improve some allergic diseases. Today there are a lot of discussions about the effects of chronic stress which has lasted for years and decades. Many unpleasant events from the past, such as fear, aggressive wishes, guilt and others, can have its effect on the body systems later, and gradually cause functional disorders and organic diseases within them. Enhanced work of the nervous system and increased secretion of hormones, which can protect us when the stress occurs for the first time, represents the same changes which can destroy us in the end when we face constant and persistent stress. Some studies have shown that in addition to heredity, common infections of the respiratory tract and pollution of the environment are the main villains for the development of allergic diseases as well as stress. Recent studies emphasize that stress and anxiety can extend the duration of seasonal allergies and boost their symptoms.</p>

Danijela Batinić Škipina, S. Knežević Ušaj, Draga Zec, M. Čuk, Snežana Božanić, Nenad Lalović

<p><strong>Introduction. </strong>The Bcl-2 gene codes an oncoprotein, inhibits a programmed cell death or apoptosis and it plays a very important role in colorectal cancerogenesis. The aim of our study is to determine Bcl-2 expression in colorectal carcinomas in relation with the stage of disease, histology of tumor type, localization and macroscopic growth pattern. <strong>Methods.</strong> Immunohistochemichal detection of Bcl-2 protein expression was carried out on 90 resected colorectal carcinomas. The patients were divided into three groups according to the degree of Bcl-2 expression in a tumor: group 0 - there were no cells with positive immunohistochemical reaction; group I- up to 20 % of positive cells, and group II- above 20% of positive cells. The groups were compared in relation to the stage of disease, T stage of local spread of disease, histology of tumor type, localization and macroscopic growth pattern. <strong>Results.</strong> 58% of patients at the second stage of disease had no expression of Bcl-2. Higher percentage (61%) of the patients with metastases ( stages III and IV) had high level of Bcl-2 expression. Tumors with polipoid growth pattern have higher level of Bcl-2 expression. <strong>Conclusion. </strong>There is a statisticaly significant difference in Bcl-2 protein expression in patients surgically treated at the II and III stage of disease, stage T3a/b, T3c/d of local spread of disease and tumors whith polipoid growth pattern in relation to infiltrative growth pattern.</p>

S. Marić, R. Marić, V. Marić, Vjeran Saratlić, Novica Petrović, V. Mujovic

<p><strong>Introduction.</strong> Inadequate postoperative analgesia can affect the functioning of almost all organ systems and significantly increase morbidity and mortality. The aim of study was to analyze and assess response of patient&rsquo;s painful sensations caused by surgical intervention in early stage of acute postoperative pain. <strong>Methods.</strong> This paper presents a prospective study that follows the reaction of the patient 24 hours postoperatively after different surgical procedures. The only criterion for patient&rsquo;s inclusion in the study was the need for elective surgical intervention. As a source of data used were medical records with complete medical documentation. <strong>Results.</strong> The study included 126 patients. The group is divided into three subgroups: I - gallbladder surgery, II - resection of the stomach and intestines, III - surgery of hernia abdominal wall. The same analgesics are ordained postoperative: noraminofenazon, and ketoprofen. The severity of pain and testing treatment effect was carried out peacefully, at regular intervals by the appropriate scale for the assessment of the strength and quality of pain. <strong>Conclusion.</strong> At the time of the need for analgesic patients on a scale of pain showed a value of 6,84 to 7,14 (VAS - visual analog scale). Homeostatic values of variables in the early postoperative period, it remained within normal values. Administration of analgesics &ldquo;at the request&rdquo; of the patient not achieved satisfactory analgesia, because the first postoperative day the patients will have a severe pain (VAS - 7).</p>

B. Zrnić, S. Medenica, Aleksandra Salamadić, Zoran Pantić, S. Ristić

<p>Skin lesions have a strong influence on the mental health. Literature indicates the complex interrelationships between psychosocial factors and psoriasis, which substantially reduce the quality of life of these patients. These interrelationships are based on numerous interactions that exist between the immune, nervous and endocrine systems and they are the basis of interactions that exist between mental and somatic health and the environment. Psychodermatology was developed as a new interdisciplinary field, a connection between psychiatry and dermatology. More than just cosmetic disfigurement, psoriasis is associated with various psychopathological problems that may have an impact on patients, their families and society. Numerous psychological disturbances occur in patients with psoriasis. Also, a significant psychiatric comorbidity was found in patients with psoriasis. Exacerbation of psoriasis leads to a deterioration of mental health. The treatment of psoriasis requires an interdisciplinary approach of a dermatologist and a psychiatrist. Various forms of psychological interventions have been proposed as a potentially useful addition to a standard pharmacological treatment of psoriasis.&nbsp;</p>

M. Račić, Branka Debelnogić, R. Milic, Vesna Krstović Spremo, Draženka Đurić

<p><strong>Introduction. </strong>The Delphi technique is a procedure where a panel of experts distributes questionnaires and collects back information for the purpose of coming to a group consensus on a specified topic. The aim of the study was to examine the effectiveness of the Delphi technique in determining educational needs of family physicians and nurses.<strong> Methods. </strong>The first group of participants included 12 doctors and 24 nurses, employed at the Health Center Foča. The second group of participants included 17 doctors and 31 nurses, employed at the Health Center Pale. In the research the Delphi technique with three iterative questionnaires was used. <strong>Results.</strong> The doctors and nurses in both groups came to consensus about the topics, methodology and lecturers. In both groups, the case survey and practical demonstrations had the greatest mean value while only 13% of the participants indicated the traditional didactic methods. At the Health Center Pale they did not come to consensus about the kind of supervision. At the Health Center Foča they did not come to consensus about the method of evaluation. <strong>Conclusion. </strong>The Delphi technique is a flexible and quick method of investigation which can be used for analyzing educational needs. This technique becomes more valid and effective in as much as the group of experts are able to follow and analyze the information until they come to a consensus. Continuing education for doctors and nurses should be based on problem-oriented learning instead of the traditional didactic method.</p>

D. Vukičević, T. Pisanski

In this paper, we analyze the ratios of the numbers of paths p i ( G ) and p j ( G ) of different length in graph G . Namely, we are interested in the extremal values of these ratios for acyclic and cyclic graphs with given maximal degree. The values of infinum and supremum for graphs with given maximal degree are obtained. Also, the infinum of these ratios for trees with given maximal degree are obtained. Suprema for trees of given maximal degree are given when ratios of paths of length 1 and 2 are observed, and when ratios of paths of lengths 1 and 3 are observed. As the main result, a linear algorithm (in terms of maximal degree) for finding suprema of the ratios of the numbers of paths of length 2 and 3 for trees with given maximal degree is presented.

<p><strong>Introduction. </strong>Hepatitis B is a serious disease caused by hepatitis B virus (HBV). HBV can cause lifelong infection, cirrhosis of the liver and hepatocellular carcinoma. WHO estimates that more than 2 billion persons have been infected with HBV (including 350 million chronically infected). The aim of this study was to investigate the students&rsquo; knowledge and attitudes about HBV infection at the Medical Faculty Foca. <strong>Methods.</strong> The study was conducted among 37 students of the third year, 22 of the fifth year and 18 of sixth year at the Medical Faculty in Foca from November to December 2007. The students were interviewed by the anonymous survey. <strong>Results.</strong> Most of the examined students (96.1%) know that hepatitis B virus can be passed through sexual contact. Only 17% of the students have been vaccinated against hepatitis B. The main reason for not getting vaccinated for 75.4% medical students was the unavailability of the vaccine. Almost all participants (92.2%) believe that all medical students should be vaccinated against hepatitis B. <strong>Conclusion.</strong> Our results suggest that the students&rsquo; knowledge about HBV infection is on average level. Only 17% of students have been vaccinated against hepatitis B. The main reason for that is the unavailability of the hepatitis B vaccine.</p>

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