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  • 1
    Online Resource
    Online Resource
    National Library of Serbia ; 2022
    In:  Srpski arhiv za celokupno lekarstvo Vol. 150, No. 7-8 ( 2022), p. 476-479
    In: Srpski arhiv za celokupno lekarstvo, National Library of Serbia, Vol. 150, No. 7-8 ( 2022), p. 476-479
    Abstract: Introduction. Infective endocarditis is relatively rare in pediatric population, but can result in significant morbidity and mortality. Children with bicuspid aortic valve are at higher risk of developing infective endocarditis as compared to the general population. Our objective is to emphasize the importance of rapid diagnosis and proper treatment of infective endocarditis in patients with bicuspid aortic valve with the aim of preventing serious adverse events. Case outline. We report a case of a 13-year-old girl with a newly diagnosed bicuspid aortic valve who developed infective endocarditis with severe complications and underwent cardiac surgery. Recurrent fever and anemia, as well as cardiac murmur, were present for six months prior to diagnosing infective endocarditis. During the course of illness, only one of many blood cultures taken was positive for Streptococcus sanguinis. Conclusion. Patients with bicuspid aortic valve require careful evaluation for infective endocarditis, especially if recurrent fever associated with anemia is present. Delayed diagnosis of infective endocarditis is associated with serious complications.
    Type of Medium: Online Resource
    ISSN: 0370-8179 , 2406-0895
    Language: English
    Publisher: National Library of Serbia
    Publication Date: 2022
    detail.hit.zdb_id: 2577665-4
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  • 2
    In: BMC Health Services Research, Springer Science and Business Media LLC, Vol. 21, No. 1 ( 2021-12)
    Abstract: It is known that drug shortages represent a major challenge for all stakeholders involved in the process, but there is little evidence regarding insights into patients′ awareness and perspectives. This study aimed to investigate the patients-perceived drug shortages experience and their view on outcomes in different European hospital settings. Furthermore, we wanted to explore information preferences on drug shortages. Methods A retrospective, cross sectional, a mixed method study was conducted in six European hospital settings. One hospital (H) from each of this country agreed to participate: Bosnia and Herzegovina (H-BiH), Croatia (H-CR), Germany (H-GE), Greece (H-GR), Serbia (H-SE) and Poland (H-PO). Recruitment and data collection was conducted over 27 months from November 2017 until January 2020. Overall, we surveyed 607 patients which completed paper-based questionnaire. Questions related to: general information (demographic data), basic knowledge on drug shortages, drug shortages experienced during hospitalization and information preferences on drug shortage. Differences between hospital settings were analyzed using Chi-squared test or Fisher’s exact test. For more complex contingency tables, Monte Carlo simulations (N = 2000) were applied for Fisher’s test. Post-hoc hospital-wise analyses were performed using Fisher’s exact tests. False discovery rate was controlled using the Bonferroni method. Analyses were performed using R: a language and environment for statistical computing (v 3.6.3). Results 6 % of patients reported experiences with drug shortages while hospitalized which led to a deterioration of their health. The majority of affected patients were hospitalized at hematology and/or oncology wards in H-BiH, H-PO and H-GE. H-BiH had the highest number of affected patients (18.1 %, N = 19/105, p   〈  0.001) while the fewest patients were in H-SE (1 %, N  = 1/100, p  = 0.001). In addition, 82.5 %, ( N  = 501/607) of respondents wanted to be informed of alternative treatment options if there was a drug shortage without a generic substitute available. Majority of these patients (66.4 %, N = 386/501) prefer to be informed by a healthcare professional. Conclusions Although drug shortages led to serious medical consequences, our findings show that most of the patients did not perceive shortages as a problem. One possible interpretation is that good hospital management practices by healthcare professionals helped to mitigate the perceived impact of shortages. Our study highlights the importance of a good communication especially between patients and healthcare professionals in whom our patients have the greatest trust.
    Type of Medium: Online Resource
    ISSN: 1472-6963
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2050434-2
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  • 3
    Online Resource
    Online Resource
    National Library of Serbia ; 2020
    In:  Medical review Vol. 73, No. 9-10 ( 2020), p. 265-270
    In: Medical review, National Library of Serbia, Vol. 73, No. 9-10 ( 2020), p. 265-270
    Abstract: Introduction. Asthma and obesity are the most common chronic health disorders in children. Although heredity plays a significant role in their development, environmental factors and early exposure have contributed to the increasing incidence of both disorders in recent decades. The aim of the study was to estimate asthma prevalence in schoolchildren in Indjija, Srem District, Serbia, and to investigate differences in nutritional status of children with asthma as well as differences between their nutritional status and prescribed asthma medications. Material and Methods. A cross-sectional retrospective cohort study was conducted at the Primary Health Center in Indjija. Of all the medical records of children aged 6 - 14 years, a cohort of children with asthma was formed. The retrospective study evaluated their nutritional status and the prescribed asthma medications. Results. The prevalence of asthma in children aged 6 - 14 was 6.9%. Children with asthma were significantly more overweight and obese (40.5%) than children without asthma. Boys accounted for 63.7% of children with asthma, with a statistically significant gender difference. Abnormal nutritional status was found in 44.3% of children with asthma and boys with asthma were significantly more obese (23%) compared to girls (7.8%). Overweight and obese children with asthma were not prescribed significantly more medications to relieve asthma symptoms than normal-weight children. Conclusion. The prevalence of asthma among schoolchildren in Indjija was 6.9%. Children with asthma were more likely to be overweight and obese than children without asthma, whereas boys with asthma were significantly more obese than girls. No significant differences were found between their nutritional status and prescribed asthma medications.
    Type of Medium: Online Resource
    ISSN: 0025-8105 , 1820-7383
    Language: English
    Publisher: National Library of Serbia
    Publication Date: 2020
    detail.hit.zdb_id: 2381028-2
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  • 4
    In: Antibiotics, MDPI AG, Vol. 11, No. 10 ( 2022-09-28), p. 1325-
    Abstract: Antibiotics are often misused, especially for the treatment of upper respiratory tract infections (URTIs) in children, where their use is unnecessary and leads to antimicrobial resistance. This study sought to explore the knowledge, attitudes and practices (KAP) of parents and pediatricians on the use of antibiotics among children and whether the level of education of parents has an impact on their KAP. The research was carried out among 1459 parents of children under 6 years of age and among 18 pediatricians. Sixty percent of pediatricians (61.1%) were prescribed antibiotics daily in their practice. Most of the surveyed parents (98.4%) state that doctors are their main source of information when deciding on the use of antibiotics in the treatment of their children. Parents with a higher level of education use television less often as a source of information when making this decision compared to parents with a lower level of education (p = 0.039, i.e., p = 0.003). The majority of parents (80.7%) knew that Panklav (amoxicillin/clavulanic acid) is an antibiotic, while 52.5% identified Pancef (cefixime) as an antibiotic. Parents with a higher level of education correctly identified antibiotics significantly more often (p 〈 0.001). This study shows that in the Republic of Srpska, parents have adequate knowledge about antibiotics, especially those with a higher level of education, who show better KAP when it comes to antibiotic use.
    Type of Medium: Online Resource
    ISSN: 2079-6382
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2681345-2
    SSG: 15,3
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  • 5
    In: Scripta Medica, Centre for Evaluation in Education and Science (CEON/CEES), Vol. 53, No. 1 ( 2022), p. 4-12
    Abstract: Background/Aim: Antibiotic use and resistance represent a growing public health issue, with a specific risk of uncontrolled use of antibiotics in children. The aim of the study was to examine differences in parental knowledge, attitudes and practices about antibiotic use in children between urban and rural areas of the Republic of Srpska. Methods: A cross-sectional study was conducted among 1459 parents of children under 6 years of age, out of which 1201 (82.3 %) lived in urban areas while 258 (17.7 %) lived in rural areas. The research is conducted among parents who brought their children to the selected primary healthcare centres and among parents of children in preschool institutions. Results: The majority of respondents (98.4 %) state that doctors are their main source of information. Only 61.2 % of respondents precisely know which drug is an antibiotic when offered different drugs and respondents from rural areas (54.3 %) more often (p = 0.012) gave more accurate answers when compared to respondents from urban areas (37.3 %). Among parents, 86 % agree with the statement that improper use of antibiotics reduces their effectiveness and leads to bacterial resistance, regardless of groups. More than a half of respondents (52.4 %) do not think that children with flu or common cold symptoms recover faster when they receive antibiotics, significantly more respondents from urban areas (p = 0.001). Respondents from rural areas significantly more often believe that antibiotics can produce harmful effects compared to respondents from urban areas (p = 0.049). Respondents from rural areas significantly more often think that antibiotic use can prevent complications caused by inflammation of the upper respiratory tract (p = 0.006). Parents from rural areas give their children antibiotics without a paediatrician's recommendation significantly more often (4.3 %) compared to respondents from urban areas (0.6 %) (p 〈 0.001). Conclusion: There are differences in parental knowledge, attitudes and practices regarding antibiotic use and antimicrobial resistance among parents in rural and urban areas. There is need for additional education of parents and for greater engagement of paediatricians in providing guidance and explanations regarding the use of antibiotics.
    Type of Medium: Online Resource
    ISSN: 2490-3329 , 2303-7954
    Language: English
    Publisher: Centre for Evaluation in Education and Science (CEON/CEES)
    Publication Date: 2022
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  • 6
    Online Resource
    Online Resource
    Wiley ; 2014
    In:  Photodermatology, Photoimmunology & Photomedicine Vol. 30, No. 1 ( 2014-02), p. 15-24
    In: Photodermatology, Photoimmunology & Photomedicine, Wiley, Vol. 30, No. 1 ( 2014-02), p. 15-24
    Abstract: Oral lichen planus ( OLP ) is a chronic immunologic mucocutaneous inflammatory disease of the oral mucosa. Since the etiopathology of OLP is idiopathic, treatment is usually symptomatic, therefore showing low predictability. Currently, topical corticosteroids are widely accepted as the standard therapy. However, for patients unresponsive to standard therapy for OLP , new treatment modalities have been sought. Phototherapy has recently been accepted as an alternative or adjunctive treatment modality for many conditions in medicine and dentistry. The aim of this study is to present the advantages and disadvantages of the different kinds of phototherapy used in treatment of OLP ( UV phototherapy, lasers, and photodynamic therapy). The main outcome measures compared were improvement of signs and symptoms and OLP recurrence. Although some phototherapy techniques in the selected articles have demonstrated limited effects, there is no solid basis in evidence for the effectiveness of any of these treatments for OLP . Therefore, further research, especially randomized controlled clinical trials with long‐term follow‐up, is needed to give any solid recommendation on the use of phototherapy in the field of OLP treatment.
    Type of Medium: Online Resource
    ISSN: 0905-4383 , 1600-0781
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2026222-X
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  • 7
    In: Frontiers in Pharmacology, Frontiers Media SA, Vol. 14 ( 2023-3-15)
    Abstract: Introduction: Antimicrobial resistance and the rapid spread of multiresistant bacteria represent one of the main public health problem in limited resources countries. This issue is significantly worsening since the COVID-19 pandemic due to the unreasonably increased antibiotics prescription to patients with confirmed SARS-CoV-2 infection. The aim of this study was to examine whether COVID-19 pandemic (2020, 2021) was associated with increased antibiotic consumption in inpatient and outpatient settings in the middle size urban region (Republic of Srpska/Bosnia and Herzegovina) in comparison to period before the pandemic (2019). Additionally, we aimed to determine antimicrobial resistance and the presence of multiresistant bacteria in the regional hospital (“Saint Apostol Luka” Hospital Doboj) in 2021. Methodology: The consumption of antibiotics in inpatient was calculated as Defined Daily Dose per one hundred of patient-days. The consumption of antibiotics in outpatient was calculated as Defined Daily Dose per thousand inhabitants per day. Resistance of bacteria to antibiotics is expressed as a rates and density for each observed antibiotic. The rate of resistance was calculated as a percentage in relation to the total number of isolates of individual bacteria. The density of resistance of isolated bacteria against a specific antibiotic was expressed as the number of resistant pathogens/1000 patient days. Results: Antibiotic consumption in hospital setting registered during 2019, 2020 and 2021 was as follows: carbapenems (meropenem: 0.28; 1.91; 2.33 DDD/100 patient-days, respectively), glycopeptides (vancomycin: 0.14; 1.09, 1.54 DDD/100 patient-days, respectively), cephalosporins (ceftriaxone: 6.69; 14.7; 14.0 DDD/100 patient-days, respectively) and polymyxins (colistin: 0.04; 0.25; 0.35 DDD/100 bed-days, respectively). Consumption of azithromycin increased drastically in 2020, and dropped significantly in 2021 (0.48; 5.61; 0.93 DDD/100 patient-days). In outpatient setting, an increase in the consumption of oral forms of azithromycin, levofloxacin and cefixime, as well as parenteral forms of amoxicillin-clavulanic acid, ciprofloxacin and ceftriaxone, was recorded. In 2021, antimicrobial resistance to reserve antibiotics in hospital setting was as follows: Acinetobacter baumanii to meropenem 66.0%, Klebsiella spp to cefotaxime 67.14%, Pseudomonas to meropenem 25.7%. Conclusion: Recent COVID-19 pandemic was associated with increased antibiotic consumption in inpatient and outpatient settings, with characteristic change of pattern of azithromycin consumption. Also, high levels of antimicrobial resistance to reserve antibiotics were registered in hospital setting with low prevalence of identified pathogen-directed antimicrobial prescription. Strategies toward combat antimicrobial resistance in the Doboj region are urgently needed.
    Type of Medium: Online Resource
    ISSN: 1663-9812
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2587355-6
    SSG: 15,3
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  • 8
    In: Frontiers in Pharmacology, Frontiers Media SA, Vol. 11 ( 2020-3-26)
    Type of Medium: Online Resource
    ISSN: 1663-9812
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2020
    detail.hit.zdb_id: 2587355-6
    SSG: 15,3
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  • 9
    In: Scripta Medica, Centre for Evaluation in Education and Science (CEON/CEES), Vol. 52, No. 3 ( 2021), p. 165-173
    Abstract: Background/Aim: The prevention of cardiovascular risk factors and cardiovascular disease management contributes to the cardiovascular mortality reduction. The effects of these activities have been measured by quality indicators. The aim of this study was to determine the effects of family medicine team training workshop and implementation of clinical guidelines on the cardiovascular risk factors and diseases management in primary health care in the Republic of Srpska/Bosnia and Herzegovina. Methods: The "CardioVascular Risk Assessment and Management" study included a sample of 373 teams from 41 primary health care centres trained to provide adequate services and to compare the quality of cardiovascular risk management before and after the training workshop and implementation of clinical guidelines. The comparison was based on nine project defined performance indicators related to hypertension, type 2 diabetes mellitus, hyperlipidaemia, tobacco smoking and obesity. Results: Significant improvements were observed in six indicators after the training workshop and implementation of guidelines. Target values for blood pressure and HbA1c were achieved in over 80 % of patients (82.12 ± 15.81 vs 84.49 ± 12.71 and 84.49 ± 12.71 vs 85.49 ± 24.55; before and after the training workshop, respectively), while the target values for LDL cholesterol were achieved in 54.98 % ± 20.33 before and 57.64 % ± 16.66 after the training workshop. The number of teams that had less than 20 % of recorded data significantly decreased after the training workshop and guidelines implementation, and adequate recording of all indicators was improved. Conclusion: The training workshop of family medicine teams and implementation of clinical guidelines resulted in significant quality improvement of cardiovascular diseases management in primary health care.
    Type of Medium: Online Resource
    ISSN: 2490-3329 , 2303-7954
    Language: English
    Publisher: Centre for Evaluation in Education and Science (CEON/CEES)
    Publication Date: 2021
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  • 10
    Online Resource
    Online Resource
    Centre for Evaluation in Education and Science (CEON/CEES) ; 2020
    In:  Scripta Medica Vol. 51, No. 2 ( 2020), p. 87-92
    In: Scripta Medica, Centre for Evaluation in Education and Science (CEON/CEES), Vol. 51, No. 2 ( 2020), p. 87-92
    Type of Medium: Online Resource
    ISSN: 2490-3329 , 2303-7954
    Language: English
    Publisher: Centre for Evaluation in Education and Science (CEON/CEES)
    Publication Date: 2020
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