Introduction: Key problems when transferring results of pharmacoeconomic studies between countries are: relative infrequency of observational design, utilization of unreliable estimates of input parameters in many of modelling studies, not reporting variability of the study outputs (e.g. ICER, net monetary benefit) in a publication, and large differences in costs of healthcare services and drugs from country to country. Aim: The aim of this study was to estimate Incremental Cost-effectiveness Ratio (ICER) of denosumab vs. alendronate for treatment of osteoporosis in postmenopausal women in Serbia, using results of published pharmacoeconomic studies in United States of America (USA) and Japan. Material and Methods: The estimate of the ICER was made through the following steps: (1) scaling the ICER of the published studies to Serbian healthcare milieu using unit costs in Serbia, USA and Japan; (2) defining prior distribution of the ICER using adjusted results of the earlier published study; (3) defining sampling distribution of the ICER using adjusted results of the next published study; (4) estimating posterior distribution of the ICER and calculating the most probable values the ICER with Bayesian statistics. Results: The ICER of the prior distribution was 572,787.00 RSD, with 99% confidence interval from 1,116.00 to 998,051.00 RSD, and that of the sampling distribution 706,057.00 RSD, with 99% confidence interval from 1,122.00 to 999,308.00 RSD. The most probable ICER value from the posterior distribution was 752,912.00 RSD, with 99% confidence interval from 667,631.00 to 771,552.07 RSD. The estimated ICER was below one Gross Domestic Product (GDP) of Serbia per capita (the 2019 value: 780,063.60 RSD). Conclusions: Denosumab should be considered cost-effective in Serbia if one to three GDPs/capita/Quality Adjusted Life Year (QALY) gained is taken as the upper limit of willingness to pay by Serbian Health Insurance Fund.

Introduction: Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) is a rare, severe, systemic, drug-induced hypersensitivity syndrome, the most frequently associated with anticonvulsants. Case Report: A 35-years-old woman with a history of depression and hypothyroidism developed fever 39.5°C, enlarged, painful neck and axillary lymph nodes, slight facial edema around the mouth, confluent maculopapular rash, and laboratory signs of hepatocellular injury, leukocytosis and lymphopenia, but with normal eosinophil count. The syndrome was evident two weeks after starting carbamazepine, and gradually decreased after withdrawal of this drug and introduction of corticosteroid therapy. Conclusion: If a patient is taking carbamazepine and develops skin rash as well as fever and swollen lymph nodes, the physician should always check for internal organ damage and possible DRESS syndrome.

Bacground/Aim. Treatment of neurological diseases usually requires polypharmacy, and it is crucial to detect potential drug-drug interactions (DDIs) and recognize risk factors on time, as consequences of DDIs could be serious. The aim of the study was to analyze risk factors for the occurrence and the number of potential DDIs among patients in a general neurological ward. Methods. This study was conducted with 144 inpatients in a general-care neurological department of a tertiary care hospital. The effects of risk factors for potential DDIs were evaluated by multiple linear regression. The study had retrospective cohort de-sign. Frequencies of various types of potential DDIs (according to severity) were discovered by Medscape, Epocrates and Micromedex online interaction checkers. Results. The number of prescribed drugs, age of a patient, value of the Charlson comorbidity index and prescription of an antidepressant increase risk of potential DDIs in a general neurology ward. On the other hand, being paralyzed, number of prescribers for a single patient, being bedridden for at least one day of hospitalization decreased the number of potential DDIs per patient. Number of prescribed drugs per patient [odds ratio (OR) = 1.466 ? 0.250; p = 0.000) and age (OR = 1.027 ? 0.026; p = 0.041)] increased, and number of prescribers per patient (OR = 0.056 ? 0.028; p = 0.016), especially if the patients were paralyzed (OR = 0.214 ? 0.294; p = 0.007), decreased the risk of contraindicated, serious, ?use alternative? or major potential DDIs. Antidepressants increased the risk of absolute number of all monitor/modify potential DDIs (OR = 1.257 ? 0.726; p = 0.035). Conclusion. Frequency of potential DDIs among neurological patients is considerable and influenced to the largest extent by advanced age, comorbidities, total number of pre-scribed drugs per patient and concomitant use of antidepressants.

Introduction: Patients with Parkinson's disease are exposed to higher number of drugs on average than other elderly persons. Levodopa, of the mainstay of Parkinson's disease therapy, is frequently interacting with numerous drugs. Aim: The aim of this study was to identify predictors of potential drug-drug interactions (pDDIs) in hospitalized patients suffering from Parkinson's disease (PD). Material and Methods: This was a academic retrospective cross-sectional study in PD patients hospitalized at the Clinic of Neurology, Clinical Center Kragujevac. Medical records of hospitalized patients during the period 1.1.2017 - 31.12.2019 were analysed. The pDDIs were identified by means of Micromedex andLexi-Interact online softwares, and multivariate regression methods were used to reveal potential predictors of number of pDDIs per patient. Results: Micromedex detected 160 different pDDIs in 77.8% of 72 patients with PD. The most frequent pDDIs were those that involved aspirin (with bisoprolol, sertraline and perindopril). Predictors of pDDIs in general was total number of drugs, while use of antidepressants presented a significant risk factor for major pDDIs. Lexi-Interact revealed 310 pDDIs in 98.6% of patients. The three most common pDDIs were with levodopa (bisoprolol, clonazepam, perindopril). Total number of drugs, number of co-morbidities, hospitalization at the neurodegenerative ward, and use of antipsychotics were identified as the relevant predictors of pDDIs. Lexi-interact software detected significantly more pDDIs than Micromedex (p<0.001). Conclusion: Neurologists should pay special attention when deciding whether to administer new drug to a PD patient with multiple comorbidities, hospitalized in a neurodegenerative ward and/or taking antidepressant or antipsychotic drugs.

Introduction: The clinical significance of potential drug-drug interactions (pDDIs), especially in the intensive care unit (ICU) manifested mostly as adverse drug reactions. Aim: The goal of this research was to conduct a focus group, in which the participants were decisionmakers in acute ischemic stroke patient treatment. Also, the aim was to reach a consensus, due to the Delphi process, between neurologists and clinical pharmacologists regarding this highly vulnerable group of patients. Material and Methods: In this academic research, so-called applied focus group (the goal was to reach practical decisions) and clinical focus group (determining motives, predeterminations, bias, prejudice and analyzing the behavior leading to a certain outcome) was done. Results: Continuing medical education of neurologists is needed regarding pDDIs and the use of an online pDDIs checker. Certain groups of patients with AIS are at particular risk of exposure to pDDIs. Certain drug groups are more likely to interact with other drugs. Conclusions: Defining medical recommendations/guidelines on evidence base medicine about pDDIs in patients with AIS would significantly contribute to reducing their frequency in this vulnerable patient population.

. Background: Computer simulations can be briefly described as the use of computers to represent the dynamic responses of a tested system, by observing the behavior of another, artificial, system modeled on basis of the test system. Physical modeling has been practiced unconsciously since the beginning of the human species, that is, from the moment when the human mind began to understand all the complexity of phenomena and things that surrounded it in nature. Objective : The aim of this paper is to analyze the implementation of computer's simulation and modeling for educational agenda. Methods : This article is a review of the entire to use models, modeling and simulation by using compiters and ICT for teaching system in undergraduate, postgraduate and continuing education using published information, as well as professional papers and publications about this topic. The simulation methodology is based on computer science, statistics, numerical mathematics, operational research and artificial intelligence, but today it is sufficiently coherent and developed that it can rightly be called a separate scientific discipline. The system model represents a simplified and idealized (abstract) image of a real system. In other words, a model is a description of a real system with all its characteristics that are relevant from our point of view. Results and Discussion: Application of computer simulations in science: Different simulations are used to meet specific requirements of the scientific field and the problem such as: Numerical simulation of a differential equation, which cannot be solved analytically. This category includes theories dealing with continuous systems, such as phenomena in physical cosmology, fluid dynamics ; Stochastic simulation, used for discrete systems, where changes occur on the basis of probability, and cannot be explained by equations. These include genetic changes, and biochemical and genetic regulatory processes; Modeling of molecules and their behavior for the purpose of creating drugs; CFD–Computational Fluid Dynamics.–computers are used to perform calculations, which describe the behavior of liquids and gases; Blue Brain project; Cognitive architecture and Movement of parasites in the human body. Conclusion: This paper presents explanations and examples of the application of computer simulations in order to solve everyday problems encountered, both in medicine and all other branches of science. Conclusion: Computer simulations are an invaluable blend of nature and technology, and are one of the main sources of hope for understanding and improving the world we live in.

The main objective of this study is to provide a critical insight into the position of regional geography in modern geosciences, i.e. to examine the epistemological, methodological, practical and educational function of this synthetically oriented geographical discipline on a theoretical level. For this purpose, we have reviewed a number of readings selected from various published scientific papers and textbooks, which provide some sort of review of the modern concept of regional geography and the notion of region. The 1980s can be taken as the initial period of revitalization and redefinition of regional geography, when in addition to the traditional approach based on chorology, there was also the so-called new regional geography. The dominant concepts found in both these schools were evaluated by using the method of dialectical analysis and synthesis, on the basis of which the guidelines were proposed for future positioning of the spatial determination of the region within the geographical sciences. The general conclusion is that regional geography should not be viewed exclusively through the prism of idiographic concept, but the necessity would also be to aspire to discover the general spatial correlation patterns and regularities through various regional studies.

<p style="text-align: justify;">The aim of this paper is to present a sufficiently adequate and accurate mathematical model of the breaking force of a solid wood panel. For that purpose, an experiment with thirteen repetitions was designed and done. The input sizes that varied on three levels are the density of the wood and the thickness of the solid wood panel. Since the central composite plan with thirteen repetitions of the experiment also includes four repetitions in the marginal areas, two more wood densities and two solid wood panel thicknesses were taken. The force was measured in such a way that the plate fibers were parallel to the bending direction of the plate. The measurements were made in the laboratory of the Technical Faculty in Bihać. The significance of the model coefficients was determined using the R software and the results were presented using the Design Expert software.</p>

The relationship and effects between fiscal policy and economic growth have been an important theoretical and empirical research topic. The neoclassical models imply that the economic effects of changes in government spending will be neutralised by the impact of consequent changes in private spending. Endogenous growth models, on the other hand, imply that changes in the level and composition of taxation and government expenditure can affect economic growth. This aim of the paper is to explore the relationship and effects of fiscal policy and economic growth in 21 Central and Eastern European (CEE) countries over the period 2000-2018. The results, after controlling for various common and country-specific variables, imply that an increase in taxation, but not in non-productive expenditures, can positively affect economic growth. Our main findings are: (i) there is a significant and positive contemporaneous relationship between the general level of taxation and economic growth; and (ii) there is no relationship between the government final consumption and economic growth. Therefore, our results contributed to the scientific literature by providing empirical evidence on the contemporaneous relationship between the general government tax receipt and economic growth in CEE countries.

BackgroundOrgan donation is a personal choice and many ethical, legal, medical, organisational and social factors are involved. It is possible to transplant some organs from live donors and others only from deceased donors. Nevertheless, the shortage of organs worldwide is a problem. Gender differences may cause decission and willingnes to organ donation. Methods A total of 60 informants (30 men and 30 women), born in Bosnia and Herzegovina and living in Sweden were available for follow-up. Data was collected by a questionnaire and statisticaly analysed according to the chi-square test, the D’Agostino-Pearson test for checking normality of continuous data distribution and, based on the distribution of results, Student’s t test or the Mann-Whitney test. Statistical significance was defined as p < 0.05.Results The result showed that significant differences between men and women was highest in the question about definition of transplantation (p<0.0001), information about organ donation (p<0.0001), knowledge about OD (p<0.0001), importance about OD (p<0.003), religious permitting to OD (p=0.0001), religious opposite to OD (p=0.0007), donate to a special person or not (p=0.0062), religion as factor to donate (p=0.0007). It was not better in question about having the donor card (p<0.0001). ConclusionsWomen were found to have more positive attitudes toward organ donation than men. Different socioeconomic factors, cultural beliefs, a higher level of religiousness, a higher level of information and knowledge about organ donation, as well as the ownership of donor cards, may result in a better perception of and willingness to participate organ donation. More knowledge of the religious understanding of organ donations and the reduction in prejudice among respondents would make the awareness and desire for organ donation even greater.