<abstract><title style='display:none'>Abstract</title>The goal of this paper is to determine the level of patient satisfaction with health care among adults in the Republic of Serbia and to analyze the correlation between the satisfaction and socio-demographic characteristics of the interviewees. The paper is based on the data provided by the National health survey of the Republic of Serbia. For the purposes of this paper, we used data on age and household of the people aged 19 and more. By eliminating the interviewees who were neither satisfied nor dissatisfied with the health care services, we obtained the sample containing 18.206 interviewees. Demographic characteristics and well-being index represented independent variables in the research. Dependent variable of the patient satisfaction was transformed into a binary variable by categorizing satisfied and very satisfied interviewees into one group and by placing dissatisfied and very dissatisfied interviewees into group of dissatisfied patients. The connection between satisfaction and predictors was examined using Chi-Square test and logistic regression. The percentage of the satisfied patients with health care was 72.9%. The satisfaction level was directly connected to age, gender, marital status, employment, region the interviewee comes from and well-being index. Patients who were more satisfied included older people, women, as well as married people, the unemployed and those living in the cities. The analysis of the financial situation shows that the poorest interviewees were the most satisfied with health care.</abstract>

The Effect of Sociodemographic Factors on the Patient Satisfaction with Health Care System

<abstract><title style='display:none'>Abstract</title> Orthostatic hypotension (OH) is defined as a drop in the systolic blood pressure greater than 20 mmHg and that of the diastolic blood pressure greater than 10 mmHg within 3 minutes from the change of the body’s position from lying or sitting down to standing up. The objective of this study is to analyse the incidence and severity of orthostatic hypertension when taking one of the generic representatives of the ACE inhibitor group (trandolapril) as a monotherapy in patients with essential hypertension. Th e study involved 314 patients (medium age of 54±4 years; 52.5% men) with poorly regulated hypertension for whom trandolapril was introduced as monotherapy. Th e incidence rates of patients with and without orthostatic hypotension between the first and second examination were not statistically significantly different. At the second control examination, 7 patients (2,3%) still had orthostatic hypotension, as was the case at the first examination. Between the third and fourth controls, a statistically significant decrease in the number of patients with orthostatic hypotension was recorded. No statistically significant difference in the incidence of orthostatic hypotension between patients with normal body mass and those who were overweight was observed. Our study has shown that certain ACE inhibitors, such as Trandolapril, do not have a pronounced adverse effect with regard to orthostatic hypotension and that in long-term application, they can have a positive role in the prevention of hypotensive episodes and improving patient compliance.</abstract>

Orthostatic Hypotension and Therapy with an Ace Inhibitor in Hypertensive Patients

<abstract><title style='display:none'>ABSTRACT</title> Reconstruction of infrabony defects created by the chronic inflammatory processes of parodontopathy represents a major clinical problem in paradontology. The objective of this research was to compare and evaluate the efficiency of two bone substituents at reversing the deep infrabony defects in the paradentium after the application of a new “Biohapel” material consisting of biphasic calcium phosphate/poly DL-lactide-co-glycolide. This study included 12 patients of both genders with an average age of 49.7 years who were suffering from clinically manifested parodontopathy. The main criteria for selecting patients were the presence of six similar infrabony periodontal defects that were at least 4 mm deep and in the lower side of the teeth on both sides of the jaw. After applying a basic causal parodontopathy treatment, defects were divided into two groups, including an experimental group (n=72) in which defects were reconstructed using the “Biohapel” bone substituent (on one side of the lower jaw) and a control group (n=72) in which infrabony defects were reconstructed using β tricalcium phosphate (βTCP) (CerasorbR), a preparation very commonly applied in regenerative parodontopathy treatment (on the other side of the lower jaw). Markers to assess treatment efficacy were determined before surgery and 6 months after surgery by measuring the depth of periodontal pocket and the level of the junctional epithelium. We observed statistically significant differences in the periodontal regeneration markers between the experimental and control groups (p&lt;0.05). Application of “Biohapel” during the surgical treatment of infrabony defects in the paradentium significantly improves the bone regeneration of the paradentium when compared with the standard application of β-tricalcium phosphate .</abstract>

Evaluaton of the Use of Bone Implants as a Therapy for Deep Defects in the Parodoncium

<abstract><title style='display:none'>Abstract</title>Chronic tinnitus is often associated with hearing impairment, but it cannot be asserted that only hearing loss causes tinnitus. Audiograms of patients with tinnitus show that hearing loss occurred more often at high frequencies than at low frequencies.The aim of this study was to analyse the audiogram shapes of patients with chronic tinnitus and to identify the relationship between the shape of the audiogram and intensity and duration of tinnitus.This investigation was a cross case series study conducted at a general hospital in Kraljevo on patients with chronic subjective tinnitus. The study included 43 patients of both genders and of different ages. We used audiometry (measuring the threshold of hearing for frequencies from 250, 500, 1000, 2000, 4000 and 8000 Hz) and tympanometry. Each patient reported the intensity of tinnitus in each ear on a visual analogue scale (VAS1) and stated the duration of tinnitus for each ear.Our research showed that patients with chronic tinnitus had a characteristic audiogram with progressive hearing loss to high frequencies. Th is difference was significantly increased starting from lower to higher frequencies, and the most hearing-decreased range (“edge”) was between 2000 and 4000 Hz. We did not find a strong link between the tinnitus intensity measured by the visual analogue scale and tinnitus duration on one side and hearing loss in the studied patients and audiogram shape on the other side. The duration of tinnitus was most associated with hearing loss at 2000 Hertz, but even that was not significant.</abstract>

Is There a Relationship Between Audiogram Shape and the Intensity and Duration of Tinnitus?

<abstract><title style='display:none'>Abstract</title>Intracranial aneurisms are ongoing problem for neurosurgeons and especially for interventional neuroradiologists due to its morbidity and mortality. The method of choice for treatment of the unruptured and ruptured intracranial aneurysms is endovascular coiling on account of its minimal invasiveness and high effectiveness. The aim of our study was to evaluate the safety and successfulness of endovascular coiling procedure in unruptured and ruptured intracranial aneurysms.Our study was designed as case series and consisted of patients older than 18 years, who underwent endovascular coiling of unruptured and ruptured intracranial aneurysms and follow-up examination 6 months after the interventional procedure. The procedures were performed from December 2010 to December 2016, by experienced interventional neuroradilogists (more than 400 performed embolizations each) at the Department for Interventional Neuroradiology, Clinical Center Kragujevac, Serbia.There were 681 patients (average age 47.5 ± 11.2 years) treated with endovascular coiling, out of them 324 (234 females, 90 males) had unruptured intracranial aneurysm and 357 (138 females, 219 males) had ruptured intracranial aneurysm. In our series, total complication rate was 11.71 %. Analysis of the results after first endovascular procedure has shown that complete aneurysm occlusion was accomplished in 546 patients (80.3%), near-complete in 81 patients (11.8%), and incomplete in 54 patients (7.9 %).Our results were satisfying regarding the procedure’s success, safety, outcomes and study material. However, further technical development of the materials and constant training of the interventional radiologists, are a necessity in order to improve treatment outcomes and patients’ benefit.</abstract>

Evaluation of Safety and Successfulness of the Coil Embolization of Intracranial Aneurysms

<abstract><title style='display:none'>Abstract</title> Plants have an important role in maintaining people’s health and improving the quality of human life. They are an important component of people’s diet, but they are also used in other spheres of human life as a therapeutic resources, ingredients of cosmetic products, paints and others. The Daphne genus belongs to family Thymeleaceae which includes 44 families with approximately 500 herbal species. The plant species of the genus Daphne are used in the traditional medicine in China and tropical part of Africa for the treatment of various conditions. Previous studies showed significant biological potential of these species as a source of pharmacologically active compounds. This indicates that this genus possess a broad spectrum of biological activity including antimicrobial, antioxidant, analgesic, anti-inflammatory, cytotoxic, anti-ulcerogenic, abortive, hypocholesterolemic and hemostatic effects. Additionally, Daphne plants are the source of valuable bioactive phytochemicals such as coumarins, flavonoids, lignans, steroids and different classes of terpenes. Different parts of the Daphne plants contain specific bioactive metabolites and can represent a source of new, natural, pharmacologically active compounds, which may potentially be used in pharmaceutical, cosmetic and food industries.</abstract>

Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Svetozara Markovicá, 34000 Kragujevac,

Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac,

Plants from The Genus Daphne: A Review of its Traditional Uses, Phytochemistry, Biological and Pharmacological Activity

<abstract>
<title style='display:none'>Abstract</title>
Periodontal diseases involve several conditions that are defined by pathologic loss of the periodontal ligament and alveolar bone. Periodontitis is an inflammatory disease of periodontal tissue caused by a host immune response to dysbiotic microbial biofilm whose progression associated with destruction of tooth supporting tissue is promoted by host proteinases. Periradicular periodontitis is the most commonly diagnosed disease that affects the pathology of periodontal tissue in the area of the tooth root. This disease has also been described as apical periodontitis. Several experimental models of periodontal diseases have been developed in recent years. This paper provides an overview of experimentally induced animal models of periodontal disease (periodontitis and periradicular periodontitis) and the possibility of using different experimental animals to study aspects of periodontal disease, each with advantages and disadvantage.
</abstract>

Experimental Animal Models of Periodontal Diseases

<abstract>
<title style='display:none'>Abstract</title>
The quality of life of people with multiple sclerosis is not only influenced by factors that lead to neurological disability or factors from the spectrum of a person’s demographic characteristics, but also by various mental and psychological factors that lead to altered states of these people. The aim of the research was to determine the correlation of anxiety and depression with the quality of life of people with multiple sclerosis. The sample consisted of 100 participants with multiple sclerosis (40% male, average age 47.8). The instruments used in the research included: The Beck Depression Inventory, The State-Trait Anxiety Inventory and Multiple Sclerosis Quality of Life Instrument. 75% of our participants showed significant symptoms of state anxiety, and 71% of them showed significant symptoms of trait anxiety. At the same time 59% had minimal depression and 7% had severe depression. A negative correlation was found between state anxiety and physical health (r = -0.609, p &lt; 0.01), trait anxiety and physical health (r = -0.757, p &lt; 0.01), state anxiety and the mental health (r = - 0.639; p &lt; 0.01), trait anxiety and mental health (r = -0.819, p &lt; 0.01), as well as depression and physical health (r = - 0.670, p &lt;0.01) and depression and mental health (r = - 0.750, p &lt;0.01). Depression and anxiety correlate negatively with quality of life and require psychosocial and social support planning programs in rehabilitation of people with multiple sclerosis.
</abstract>

The Association of Anxiety and Depression with the Quality of Life of People with Multiple Sclerosis

<abstract>
<title style='display:none'>Abstract</title>
The accessory navicular (AN) is a bony formation located on the medial side of the foot, proximal to the navicular and continuous with the posterior tibialis tendon. It emerges as a developmental variant due to the presence of the secondary ossification center adjacent to the primary center of the navicular. It is regarded as a physiological and anatomical variant. In most instances, this is an incidental finding. Radiographic values are used to define three types of AN based on its relationship with the navicular. The symptomatic AN causes pain in the medial portion of the bone, a decreased range of motion and discomfort with shoe wearing. In case of recurrent symptoms, following an inadequate diagnosis and treatment, it can result in acquired flatfoot. Our case study examined the condition of asymptomatic AN in a young man with both flatfeet, who was initially treated conservatively, and then, after the failed response to the therapy, surgically. Following the Kidner procedure (excision with the reattachment of the insertion in the posterior tibialis tendon) and rehabilitation, the patient reports no subjective symptoms in the period of 12-month monitoring. An objective examination was conducted with the use of FE analysis during weight-bearing. We determined a reduction in total weight-bearing and the pressure distribution to the lateral side of the foot, metatarsal, and the heel region.
</abstract>

FE Analysis of the Symptomatic Navicular - A Case Report

<abstract>
<title style='display:none'>Abstract</title>
Social factors such as social support, integration, and belonging to the community are positive resources against adverse events and living conditions. This study at examining the influence of social support on depression among elderly people in Serbia. The research was done according to the type of cross-sectional study, a mass survey of a random, representative stratified two-stage sample of the population of Serbia in 2013, which was conducted by the Ministry of Health of the Republic of Serbia. The target population consisted of 3540 respondents aged 65 and over. The Patient Health Questionnaire-8 (PHQ-8) was used to evaluate the presence of depressive symptoms and the social support score from the questionnaire Oslo-3 scale of social support. The relations between depression symptoms and social support were examined with univariate logistic regression analyses. In the univariate regression model, social support stood out as a strong predictor of depression. People with weak social support are three and a half times more likely (OR = 3.45) to have depression compared to those with strong social support. Men with small social support were more likely to have depression (OR = 5.08) than women (OR = 3.41). These results indicate the urgency of addressing depression as a public health priority to reduce the burden and disability and improve the overall health of the elderly population.
</abstract>

The Influence of Social Support on Depression Among Elderly People in Serbia

<abstract>
<title style='display:none'>Abstract</title>
Functional dyspepsia (FD) is a syndrome mostly diagnosed by subjective patients’ symptoms after excluding organic, systemic and metabolic diseases. Aim: The goal of this study is to evaluate gastric emptying in patients with functional dyspepsia, by measuring the antral area (cm2) after the intake of a test meal using ultrasonography as an objective and widely applicable method. Material and Methods: This study included 30 patients (mean age of 46.53 ±9.73 years) with symptoms of FD according to the ROMA IV criteria and 30 healthy individuals (mean age of 42.87 ±4.42 years). A 5 MHz ultrasound probe was used to measure the stomach antral area at 6 different time points: in the fasting state, following the meal intake at 5, 30, 60, 90 and 120 min postprandially. Results: The antral area was statistically significantly larger after a 30-minute postprandial period in patients with FD comparing to healthy controls (p&lt;0.05). There was a statistically significant difference in the rate of gastric emptying at 120 minutes in patients with functional dyspepsia, compared to healthy subjects (p &lt;0.01). Patients with postprandial distress syndrome had the average value of gastric emptying 48.25 compared to 56.09 in patients with epigastric pain syndrome (p &lt;0.05). The slowest emptying was observed in patients with nausea and postprandial fullness (p &lt;0.05). Conclusion: Functional dyspepsia is associated with delayed gastric emptying. Using ultrasonography to measure the antral area helps us to assess gastric emptying and therefore to assess patients with functional dyspepsia. The antral area was significantly larger in patients with functional dyspepsia compared to healthy subjects after the test meal, suggesting slower gastric emptying in the dyspeptic patients. Since the diagnosis of functional dyspepsia is based mostly on diverse patients’ symptoms, using ultrasonography to measure the antral area helps us to objectively assess this problem.
</abstract>

The Role of Ultrasonography in the Diagnosis of Functional Dyspepsia

<abstract>
<title style='display:none'>Abstract</title>
Early exposure to digital media has become an integral part of everyday life, which is frequently being reported as one of potential risk factors for a number of developmental disorders, including language development in infants and toddlers. The current article represents introduction to a research study which will be dealing with a potential link between the risk of language delay and excessive screen media time in children. With this in mind, we will present three case reports involving young children who experienced a language delay, but did not have any health problems diagnosed, nor did they have any of the physical high-risk factors for language and other developmental disorders detected. What these three children have in common is the fact that they were all excessively exposed to digital media during the first two years of life. The existing empirical findings suggest that different forms of digital content may be overstimulating for the developing brain, which is true both for active and background screen viewing. Moreover, screen time may be seen as a distraction from other more developmentally important activities. Keeping parents informed about a potential negative influence of prolonged media exposure can prompt parents to make informed decisions about whether and to what extent they will expose their children to digital media in the earliest period of their development.
</abstract>

Excessive Screen Media Exposure and Language Delay in the Development of Infants and Toddlers - Three Case Reports

Institute of Aging, Graduate School, Department of Economics, Hosei University, Tokyo, Japan

Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia

Health Financing Constrained by Population Aging - An Opportunity to Learn from Japanese Experience / Finansiranje Zdravstvene Zaštite U Uslovima Starenja Popualcije - Prilika Da Učimo Na Japanskom Iskustvu

<abstract><title style='display:none'>Abstract</title> The acronym ‘BRIC’ was coined in 2001 to describe the largest and most promising emerging markets outside the established, post-war, high-income economies. The nominal GDP growth rates of Brazil, Russia, India and China outpaced the growth rates of Western Europe, North America and Japan before, during and after the global economic crisis. Th is global phenomenon will have a significant impact on many branches of the economy, including the global demand for and provision of healthcare services. The key driver of this economic development is the existence of an enormous middle class in each of the BRIC countries. Both health insurance coverage and the package of services covered by health insurance plans are expanding in BRIC countries. Equally important is the overall increase in purchasing power in BRIC nations, which has been followed by the increased affordability of a vast portion of the medical goods and services that are commonly paid for out-of-pocket by ordinary citizens. When considering the changing landscape of global health care, one should also account for the slow and steady economic growth of most mature, saturated markets. Th is supports the notion that although consumer demand for health services remains strong in wealthy countries, the true expansion of the global market is occurring elsewhere. All major market analysis agencies have acknowledged this development and urged multinational healthcare companies to focus on emerging markets, and BRICs in particular, if they want to survive. Investment in emerging markets will remain the key to long-term profits and sustainability for pharmaceutical firms and medical equipment manufacturers across the globe for many years to come.</abstract>

The Key Role of the Leading Emerging Bric Markets in the Future of Global Health Care

<abstract><title style='display:none'>Abstract</title>Due to their differentiation capacity and potent immunosuppressive and pro-angiogenic properties, mesenchymal stem cells (MSCs) have been considered as new therapeutic agents in regenerative medicine. Since most of MSC-mediated beneficent effects are a consequence of their paracrine action, we designed MSC-based product “Exosomes Derived Multiple Allogeneic Proteins Paracrine Signaling (Exosomes d-MAPPS), which activity is based on MSCs-derived growth factors and immunomodulatory cytokines capable to attenuate inflammation and to promote regeneration of injured tissues. Interleukin 1 receptor antagonist (IL-1Ra) and IL-27 were found in high concentrations in Exosomes d-MAPPS samples indicating strong anti-inflammatory and immunosuppressive potential of Exosomes d-MAPPS. Additionally, high concentrations of vascular endothelial growth factor receptor (VEGFR1) and chemokines (CXCL16, CCL21, CXCL14) were noticed at Exosomes d-MAPPS samples suggesting their potential to promote generation of new blood vessels and migration of CXCR6, CCR7 and CXCR4 expressing cells. Since all proteins which were found in high concentration in Exosomes d-MAPPS samples (IL-1Ra, CXCL16, CXCL14, CCL21, IL-27 and VEGFR1) are involved in modulation of lung, eye, and synovial inflammation, Exosomes d-MAPPS samples were prepared as inhalation and ophthalmic solutions in addition to injection formulations; their application in several patients suffering from chronic obstructive pulmonary disease, osteoarthritis, and dry eye syndrome resulted with significant improvement of biochemical and functional parameters. In conclusion, Exosomes d-MAPPS, due to the presence of important anti-inflammatory, immunomodulatory, and pro-angiogenic factors, represents potentially new therapeutic agent in regenerative medicine that should be further tested in large clinical studies.</abstract>

Regenerative Processing Plant-RPP, LLC, 34176 US Highway 19 N Palm Harbor, Palm Harbor, Florida,

Therapeutic Potential of “Exosomes Derived Multiple Allogeneic Proteins Paracrine Signaling: Exosomes d-MAPPS” is Based on the Effects of Exosomes, Immunosuppressive and Trophic Factors

<abstract><title style='display:none'>Abstract</title>The treatment of chronic wounds is a continuously developing research focus. The problems of excessive mechanical forces, infection, inflammation, reduced production of growth factors, and lack of collagen will affect the results of treatment. The purpose of this study was to analysse the elements that lead to long-term non-healing of chronic wounds and trophic ulcers, including diabetic foot syndrome, by determining the optimal treatment algorithm. The paper presents an analysis of the world literature on the etiopathogenesis and principles of chronic wound treatment in diabetic foot syndrome. The epidemiology of chronic wounds of different genesis is presented. The issues of physiological and metabolic disorders in chronic ulcers affecting the process of wound healing are discussed. Particular attention is paid to collagen, which is a protein that forms the basis of connective tissue; collagen ensures the strength and elasticity of the skin, which confirms the importance of its role not only in aesthetics but also in the process of wound healing. Different types of collagen and their roles in the mechanisms of chronic wound healing in diabetic foot syndrome are described. The results of clinical studies evaluating the effectiveness of medical products and preparations, consisting of collagen with preserved (native collagen) and fractionated structures, in treating chronic wounds of diabetic foot syndrome are analysed. It has been shown that the use of native collagen preparations is a promising treatment for chronic ulcers and wounds, including diabetic foot syndrome, which makes it possible to increase the effectiveness of treatment and reduce the economic costs of managing these patients.</abstract>

Biological Mechanisms of Chronic Wound and Diabetic Foot Healing: The Role of Collagen

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Experimental and Applied Biomedical Research (EABR)

 Experimental and Applied Biomedical Research (EABR) former Serbian Journal of Experimental and Clinical Research is a peer-reviewed, open access journal which publishes original...

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 Experimental and Applied Biomedical Research (EABR) former Serbian Journal of Experimental and Clinical Research is a peer-reviewed, open...