Прегледај по Аутор "Ivković, Nedeljka"
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- СтавкаBiomarkers of Stress in Saliva(University of Niš - Faculty of Medicine, Niš, 2015) Ivković, Nedeljka; Božović, Đorđe; Račić, Maja; Popović- Grubač, Dijana; Davidović, BrankicaStress is defined as a state in which homeostasis, as a dynamic balance of internal conditions necessary for the proper functioning of cells or the living organism as a whole, is affected by the action of various stressors. Stress reaction occurs as a result of stress system activities, which is located in the central and peripheral nervous system. Stress evaluation involves a qualitative and quantitative analyses and valuation of certain biologically active substances (biomarkers of stress) in body fluids that are so often associated with stress. Saliva as a diagnostic medium is being increasingly used for purposes of clinical and basic research because of its composition and content as well as the advantages of the process of sampling, as compared to traditional methods of collecting blood samples and urine samples. Cortisol, as a biomarker of stress, is the most often studied salivary biomarker, which is associated with the activation of the hypothalamic-pituitaryadrenal (HPA) axis. Since stress leads to the suppression of the immune system, values of salivary secretory IgA and salivary lysozyme, as biomarkers of stress, can be analyzed. In saliva, it is difficult to monitor acute stress parameters, catecholamines, due to their low concentrations, rapid degradation and instability in the samples. Chromogranin A (CgA) and α-amylase enzyme can be used as alternative indices of adrenergic activity during stress reactions, due to their stability in saliva and reliability of the obtained values. Stress reaction and the diseases in whose pathogenesis it participates are yet another proof of the constant interaction of physical, psychological and social factors in health / disease.
- СтавкаEvaluation of biochemical markers effectiveness in elderly malnutrition assessment(Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina, 2019) Gavran, Larisa; Pavlović, Jelena; Račić, Maja; Ivković, Nedeljka; Tušek Bunc, KsenijaAim To systematically review the scientific evidence of biomarker validity, reliability, specificity and sensitivity in identifying malnutrition in the elderly. Methods Peer-reviewed journals were searched using PUBMED and EBSCO from January 1998 to April 2018. The articles included description of the association between malnutrition blood biomarkers and validated nutritional status assessment instruments and studies were conducted among community-dwelling elderly or nursing home residents. Results The research strategy identified a total of 293 studies. This literature review picked out seven articles for follow-up evaluation. A total of sixteen blood biomarkers were identified. Six studies found a significant association between the nutritional assessment score and albumin level. Conclusion Combining serum concentrations of malnutrition biomarkers with nutritional status assessment tools has a great potential in identifying the risk of malnutrition in the elderly, while also increasing sensitivity and specificity.
- СтавкаHandgrip Strength Cut-Off Values for the Undernutrition Risk Screening among Elderly Men and Women in Bosnia and Herzegovina(Hindawi, 2019) Račić, Maja; Pavlović, Jelena; Ivković, NedeljkaObjectives: To determine the optimal cut-off points of handgrip strength (HGS) to identify the undernutrition risk among individuals older than 65 years of age in Bosnia and Herzegovina. Design: Cross-sectional study. Setting: Towns of Sarajevo, Foca, Rogatica, and Pale in Bosnia and Herzegovina. Participants: 300 community-dwelling older adults and 146 nursing home residents. Comprehensive Geriatric multidimensional assessment (CGA) was carried out to evaluate general health, functional, and cognitive capabilities. Nutritional status and undernutrition risk were assessed by Mini Nutritional Assessment (MNA) and Seniors in the Community: risk evaluation for eating and nutrition, version II (SCREEN II). HGS was measured with a Smedley dynamometer. Results: According to the classification of nutritional status by MNA, 42% of community-dwelling men and 39% of community-dwelling women were at undernutrition risk. The undernutrition risk was significantly higher among nursing home residing men (89%) and women (78%) (p < 0.001). When nutritional status was assessed by SCREEN II, 100% on nursing home residents, 86% of community-dwelling men and 80% of women were identified as having a high risk for undernutrition. Per MNA, HGS cut-off thresholds were 23.50 kgF (65-74 years) and 19.50 kgF (≥75 years) for men; 15.50 kgF (65-74 years) and 13.50 kgF (≥75 years) for women. Per SCREEN II, cut-points were 28.50 kgF (65-74 years) and 24.50 kgF (≥75 years) for men; 24.50 kgF (65-74 years), 19.50 kgF (≥75 years for women). Conclusion: HGS can be a useful instrument to identify undernutrition risk among the elderly patients. This study provides threshold for men and women older than 65 years of age in Bosnia and Herzegovina.
- СтавкаQuality of diabetes care in family medicine practices in eastern Bosnia and Herzegovina(Elsevier, 2015) Račić, Maja; Kusmuk, Srebrenka; Mašić, Srđan; Ristić, Siniša; Ivković, Nedeljka; Djukanović, Ljubica; Božović, DjordjeObjectives: In the present study, the audit of medical files of patients with diabetes, followed in family medicine practices in the eastern region of Bosnia and Herzegovina (BiH), was carried out in order to investigate the frequency of the use of screening tests for early diagnosis of diabetes complications. Methods: The audit was conducted in 32 family medicine practices from 12 primary health care centers in the eastern part of BiH over one-year period (March 2010 to March 2011). A specially established audit team randomly selected medical files of 20 patients with diabetes from the Diabetes Registry administered by each family medicine team database. Screening tests assessed are selected according to the ADA guidelines. Results: Frequency of the individual screening test varied between 99%, found for at least one blood pressure measurement, and 3.8% for ABI measurement. When the frequency of optimal use of screening was analyzed, only 1% of patients received all recommended screening tests. Conclusion: The frequency of the use of screening tests for chronic diabetes complications was found to be low in the eastern part of Bosnia and Herzegovina. Multivariate linear regression analysis showed that longer duration of diabetes and a larger number of diabetics per practice were associated with a smaller number of screening tests, but specialists in family medicine provided a higher number of screening tests compared to other physicians
- СтавкаSalivary cortisol responses to acute stress in students with myofascial pain(Serbian Medical Association, 2018) Božović, Đorđe; Ivković, Nedeljka; Račić, Maja; Ristić. SinišaIntroduction/Objective Temporomandibular disorders (TMD) are characterized by the appearance of musculoskeletal pain and dysfunction of the masticatory system. The aims of this study were to evaluate the salivary cortisol levels in students with chronic myofascial pain (MFP) related to TMD during oral exam, as well as to analyze the correlation between salivary cortisol levels, TMD-related MFP, the level of anxiety, depression symptoms, somatization, and perceived stress. Methods The study included 60 university students, who were allocated either into the group of students with MFP (n = 30) or into the control group of healthy students (n = 30). The level of salivary cortisol was measured on the exam day and during the control day when the students had no exams. Depression symptoms, somatization, perceived stress and anxiety were evaluated according to Axis II RDC/TMD, Perceived Stress Scale and State–Trait Anxiety Inventory. Results Levels of salivary cortisol were significantly higher in the group of students with MFP in all phases of measurements compared to the control group (p < 0.01). Students with MFP also showed significantly higher depression symptoms, somatization, and trait anxiety scores than the control group. No significant group differences were found on the scales measuring state anxiety and perceived stress. The level of salivary cortisol was found to be in correlation with depression symptoms, state anxiety, and perceived stress, but not with chronic pain, somatization, and trait anxiety in students with TMD. Conclusion Salivary cortisol could be an important indicator of psychological distress in TMD.
- СтавкаSalivary flow rate and decayed, missing, and filled teeth (DMFT) in female patients with schizophrenia on chlorpromazine therapy(Elsevier, 2013) Krunić, Jelena; Stojanović, Nikola; Ivković, Nedeljka; Stojić, DragicaBackground/purpose: The purpose of the study was to investigate relationship between saliva flow rates, estrogen levels, and caries prevalence in female psychiatric patients under antipsychotic therapy. Materials and methods: Sixty-one institutionalized psychiatric females (31 patients treated with chlorpromazine only and 30 patients treated with chlorpromazine and biperiden) were compared with 36 unmedicated healthy females. The unstimulated whole saliva (UWS) flow rate and serum estrogen were measured. Caries prevalence was recorded in terms of decayed, missing, and filled teeth (DMFT). Results: The UWS flow rate in the control group was 0.35 0.18 mL/min and the DMFT 18.8 5.7. In comparison, UWS flow rates were 0.25 0.15 mL/min (P Z 0.003) and 0.07 0.05 mL/min (PZ 0.000) in patients on chlorpromazine and patients on chlorpromazine as well as biperiden, respectively, and DMFT values were 22.7 4.6 (P Z 0.003) and 26.5 5.3 (P Z 0.000), respectively. Patientson chlorpromazinewithamenorrheahad reducedUWS flowrate and estrogenlevels with respect to controls (PZ0.036; PZ0.000, respectively). Correlation analysis revealed significant correlations betweenUWS flow rate and DT, DMFT, number of used drugs and estrogen level. Conclusion: It seems that chlorpromazine-induced hyposalivation included (apart from its antimuscarinic effect) a neuroendocrine effect which affected the estrogen levels.
- СтавкаThe effects of interprofessional diabetes education on the knowledge of medical, dentistry and nursing students(Academy of Sciences and Arts of Bosnia and Herzegovina, 2017) Račić, Maja; Joksimović, Bojan N.; Cicmil, Smiljka; Kusmuk, Srebrenka; Ivković, Nedeljka; Hadživuković, Natalija; Kulić, Milan; Mijović, Biljana; Mirić, Mirjana; Joksimović, Vedrana R.; Dubravac, MilenaObjectives. Interprofessional teamwork is best attained through education that promotes mutual trust and effective communication. The primary aim of the study was to evaluate the impact of interprofessional learning on knowledge about diabetes. Methods. The cross-sectional study included students of medicine, dentistry and nursing at the Faculty of Medicine Foča, Bosnia and Herzegovina. The students were randomly allocated into one of two groups. Group 1 attended an interprofessional course on diabetes while group 2 was divided into three subgroups and each of the subgroups attended an uniprofessional diabetes course. The measuring instrument used in the course in order to assess the participants’ knowledge about diabetic care was a test containing multiple-choice questions about diabetes. The Interprofessional Questionnaire was used to explore the attitudes, views, values and beliefs of students regarding interprofessional education (IPE). Results. No statistically significant difference in total score on the test was found between the groups at baseline, but at follow-up the difference was highly statistically significant (F=10.87; p=0.002). The students from Group 1 had better results (21.82 points), compared to Group 2 (18.77 points). The statistically significant difference was observed in mean values (t=-3.997; p=0.001), between Groups 1 and 2; the students from Group 1 obtained 20.42 points, which is considered to indicate a respectively positive self-assessment of communication and teamwork skills. However, Group 2 indicated a negative self-assessment of communication and teamwork skills. Conclusion. The findings suggest that IPE activities may provide health profession students with valuable collaborative learning opportunities.