Papers by Jelena Marinković
Health Promotion International, 2016
Today well-being attracts the attention of public health professionals who are looking to explore... more Today well-being attracts the attention of public health professionals who are looking to explore life satisfaction as a whole and its specific domains. In order to contribute in moving the measurement of subjective well-being from a primarily academic activity to the sphere of intervention, we need to assess tools to measure multidimensional well-being (MWB) adopting state-of-the-art statistical techniques. Through structural equation modelling our goal was to test a MWB model among Italian and Serbian university students and to further observe its relationships with measures of life goals' pursuing. This crosssectional pilot study was conducted on a consecutive sample of 86 Italian (45% female; M age ¼ 24.20, SD ¼ 2.02) and 83 Serbian (55% female; M age ¼ 23.52, SD ¼ 2.48) university students. Participants filled in an anonymous questionnaire investigating: self-perceived MWB, standardized control measures of wellbeing (life satisfaction and eudaimonic well-being), and commitment and stress regarding personal goal pursuing. Results evidenced how Serbians reported higher scores on MWB and on control measures than Italians. Moreover, the most frequently reported goals were to complete studies, to obtain job position and to be healthy. Exploratory and multi-group confirmatory factor analyses yielded a one-factor solution of MWB across Italian and Serbian subgroups. MWB resulted positively associated with standardized control measures in both national groups. The results support the strength of our MWB model applied to samples of young university students in Italy and Serbia. Based on such findings, future studies may adopt this instrument in larger populations of university students in these two countries.
PLOS ONE, 2016
Introduction Like many developing countries, Serbia is facing a growing burden of chronic disease... more Introduction Like many developing countries, Serbia is facing a growing burden of chronic diseases. Within such public health issue, multi-morbidity requires a special attention. Aims This study investigated the prevalence of multi-morbidity in the Serbia population and assessed the co-occurrence of chronic diseases by age and gender. Methods We analyzed data from the 2013 National Health Survey, which included 13,103 individuals 20 years old. Multi-morbidity patterns were identified by exploratory factor analysis of data on self-reported chronic diseases, as well as data on measured body weight and height. The analysis was stratified by age and gender. Results Multi-morbidity was present in nearly one-third of respondents (26.9%) and existed in all age groups, with the highest prevalence among individuals aged 65 years and older (47.2% of men and 65.0% of women). Six patterns of multi-morbidity were identified: non-communicable, cardio-metabolic, respiratory, cardiovascular, aggregate, and mechanical/mental/ metabolic. The non-communicable pattern was observed in both genders but only in the 20-44 years age group, while the aggregate pattern occurred only in middle-aged men. Cardio-metabolic and respiratory patterns were present in all age groups. Cardiovascular and mechanical/mental/metabolic patterns showed similar presentation in both men and women. Conclusions Multi-morbidity is a common occurrence among adults in Serbia, especially in the elderly. While several patterns may be explained by underlying pathophysiologies, some require PLOS ONE |
BMC Medical Education, 2015
Background: Training is the systematic acquisition of skills, rules, concepts, or attitudes and i... more Background: Training is the systematic acquisition of skills, rules, concepts, or attitudes and is one of the most important components in any organization's strategy. There is increasing demand for formal and informal training programs especially for physicians in leadership positions. This study determined the learning outcomes after a specific training program for hospital management teams.
International Journal of Public Health, 2010
Our objective was to evaluate the health literacy and its association with sociodemographic varia... more Our objective was to evaluate the health literacy and its association with sociodemographic variables, the self-perception of health and the presence of chronic conditions in primary health-care patients. A cluster survey was conducted. A total of 1,500 patients were enrolled. Functional health literacy was measured by the Serbian version of the Short Test of Functional Health Literacy in Adults. Chi-square testing and multilevel logistic regression analyses were applied. We found that health literacy was inadequate and marginal in 436 (32%) and 195 participants (14.4%), respectively, and adequate in 730 participants (53.6%). A better health literacy score was present among the following participants: younger, employed, and those with a high level of education, a good self-perception of health, a good socioeconomic status and no chronic conditions. If, on multilevel analysis, the primary health center and individual variables were included, the probability for adequate health literacy was higher among younger, employed, higher educated and those with no chronic conditions. Primary health-care patients do not have the literacy skills necessary to function adequately in the health-care environment.
Sozial- und Präventivmedizin SPM, 2005
The survey applied the World Health Organization research protocol for cross-national survey-HBSC... more The survey applied the World Health Organization research protocol for cross-national survey-HBSC: a cross-sectional study among 1540 15-year old adolescents in Belgrade was conducted. The research instrument was a self-administered questionnaire. Results: Substance abuse is associated with living in a single parent family, living in a family without support, having a poor commitment to school, displaying aggressive behaviour, and spending a lot of time with friends. Conclusions: Factors associated with adolescent substance use include social background, family, school and peers. Such associations could help to focus on better measures to eliminate or reduce the risk of substance use.
The American journal of cardiology, Jan 28, 2018
Previous studies compared clinical outcomes of early versus delayed invasive strategy in patients... more Previous studies compared clinical outcomes of early versus delayed invasive strategy in patients with non-ST-elevation acute coronary syndrome up to 1-year follow-up, but long-term data remain scarce. Our aim was to evaluate the long-term effects of immediate invasive intervention in patients with Non-ST-Segment Elevation Myocardial Infarction (NSTEMI). The Randomized Study of Immediate Versus Delayed Invasive Intervention in Patients With Non-ST-Segment Elevation Myocardial Infarction (RIDDLE-NSTEMI) was a randomized, investigator-initiated, parallel-group trial that assigned 323 patients with NSTEMI (1:1) to either immediate (median time to intervention 1.4 hours) or delayed invasive strategy (61.0 hours). The primary end point was the composite of death or new myocardial infarction (MI). At 3 years, immediate invasive intervention was associated with a lower rate of death or new MI, compared with a delayed invasive strategy (12.3% vs 22.5%, hazard ratio 0.50, 95% confidence inte...
Renal failure, 2018
In 2009, Belgrade nephrologists and general practitioners from thirteen health centers carried ou... more In 2009, Belgrade nephrologists and general practitioners from thirteen health centers carried out screening for chronic kidney disease (CKD). Three years later, medical records of patients from four health centers participating in the screening study were retrospectively analyzed in order to check whether general practitioners had continued to control patients at risk for CKD in accordance with the recommendations provided. The study included 460 patients who visited their doctor at least once in the three-year period. Data on blood pressure, ACEI use, estimated glomerular filtration rate (eGFR) and comorbidities were taken from patients' medical records. Blood pressure was not recorded in any of the three years in 42.8% and eGFR in 36.7% of the patients, but blood pressure was registered every year in 7.8% and eGFR in 4.3% of them. Over the three years, the relative number of patients with recorded blood pressure decreased from 41.7% to 17.8%, and with recorded eGFR from 41.7%...
Journal of Medical Biochemistry, 2016
SummaryBackground:Since serial analyses of NT-proBNP in patients with acute coronary syndromes ha... more SummaryBackground:Since serial analyses of NT-proBNP in patients with acute coronary syndromes have shown that levels measured during a chronic, later phase are a better predictor of prognosis and indicator of left ventricular function than the levels measured during an acute phase, we sought to assess the association of NT-proBNP, measured 6 months after acute myocardial infarction (AMI), with traditional risk factors, characteristics of in-hospital and early postinfarction course, as well as its prognostic value and optimal cut-points in the ensuing 1-year follow-up.Methods:Fasting venous blood samples were drawn from 100 ambulatory patients and NT-proBNP concentrations in lithium-heparin plasma were determined using a one-step enzyme immunoassay based on the »sandwich« principle on a Dimension RxL clinical chemistry system (DADE Behring-Siemens). Patients were followed-up for the next 1 year, for the occurrence of new cardiac events.Results:Median (IQR) level of NT-proBNP was 521...
PLOS ONE, 2016
Background Although recent studies report on the benefits of blended learning in improving medica... more Background Although recent studies report on the benefits of blended learning in improving medical student education, there is still no empirical evidence on the relative effectiveness of blended over traditional learning approaches in medical statistics. We implemented blended along with on-site (i.e. face-to-face) learning to further assess the potential value of web-based learning in medical statistics. Methods This was a prospective study conducted with third year medical undergraduate students attending the Faculty of Medicine, University of Belgrade, who passed (440 of 545) the final exam of the obligatory introductory statistics course during 2013-14. Student statistics achievements were stratified based on the two methods of education delivery: blended learning and on-site learning. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course. Results Mean exam scores for the blended learning student group were higher than for the on-site student group for both final statistics score (89.36±6.60 vs. 86.06±8.48; p = 0.001) and knowledge test score (7.88±1.30 vs. 7.51±1.36; p = 0.023) with a medium effect size. There were no differences in sex or study duration between the groups. Current grade point average (GPA) was higher in the blended group. In a multivariable regression model, current GPA and knowledge test scores were associated with the final statistics score after adjusting for study duration and learning modality (p<0.001). Conclusion This study provides empirical evidence to support educator decisions to implement different learning environments for teaching medical statistics to undergraduate medical students.
Journal of Affective Disorders, 2016
Correlations between instruments measuring the same construct reflect their concurrent validity. ... more Correlations between instruments measuring the same construct reflect their concurrent validity. Little is known about changes in correlations between such instruments employed in studies with repeated assessment. The aim of this meta-analysis was to examine the changes in correlations between depression instruments in the course of longitudinal studies. A literature search was conducted using MEDLINE and PsycINFO for the period from 1960 to 2013. The total number of collected articles was 3723, of which 61 were included. Three meta-analyses were performed for the changes in correlations between each pair of the three depression scales: Hamilton Rating Scale for Depression (HAMD), Montgomery-Asberg Depression Rating Scale (MADRS) and Beck Depression Inventory (BDI). The effect size in these meta-analyses was obtained by the z-transformation of correlation coefficients. Correlations between depression scales increased over time in 52 studies. Significant changes in correlation coefficients were found for correlations between HAMD and BDI (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001) and for correlations between HAMD and MADRS (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.001). An increase in correlations between the scales was associated with a decrease in depression scores and increase in their variability. Univariable and multivariable meta-regression models were not obtained in all three meta-analyses because of the lack of data. A finding that correlations between depression instruments tended to increase over time has significant implications for assessment of the concurrent validity of these instruments. In longitudinal designs it is important to estimate correlations between depression scales over time because different thresholds for scale correlations indicate acceptable concurrent validity at different times.
The Journal of invasive cardiology, 2010
Acute heart failure (AHF) has an adverse impact on short- and long-term outcomes in patients with... more Acute heart failure (AHF) has an adverse impact on short- and long-term outcomes in patients with acute ST-elevation myocardial infarction (STEMI). The aims of the present study were to determine independent predictors for the occurrence of AHF during hospitalization and to assess the impact of AHF on 30-day and 1-year outcomes in patients with STEMI who were successfully treated with primary percutaneous coronary intervention (pPCI). The study included 1,074 consecutive patients with STEMI who had no signs of heart failure (HF) at admission (Killip class I) and were treated with successful pPCI. Successful PPCI was defined as postprocedural TIMI 3 grade flow. Acute HF developed in 11.1% patients during hospitalization, which was predominantly mild to moderate (Killip classes II and III). Independent predictors for the occurrence of AHF were: anterior infarction, peak creatinine-kinase (CK) > 2,000 U/L and 3-vessel coronary disease. 30-day and 1-year mortality rates were signific...
Chinese medical journal, 2010
Drug-eluting stents (DES) are the most common device used in percutaneous treatment of coronary a... more Drug-eluting stents (DES) are the most common device used in percutaneous treatment of coronary artery disease. Recently, there has been an increased concern regarding their safety profile, in particular the late and very late stent thrombosis rate compared to bare metal stents (BMS). The aim of the study was to compare the reported incidence of late and very late stent thrombosis of DES and BMS in patients from published clinical studies with an extended follow-up period to four years. A search strategy was developed to identify publications reporting on late or very late thrombosis of BMS and DES available through MEDLINE and Cochrane Library databases. Two independent reviewers appraised eligible studies and extracted data. Odds ratios (OR) were calculated for each outcome and presented with 95% confidence intervals (CI). Fourteen randomized controlled trials, which were at least single blinded, were identified. There was no difference in the incidence of late and very late stent...
European Heart Journal: Acute Cardiovascular Care, 2013
Background: Studies with platelet glycoprotein IIb/IIIa receptor inhibitors (GPIs) showed conflic... more Background: Studies with platelet glycoprotein IIb/IIIa receptor inhibitors (GPIs) showed conflicting results in primary percutaneous coronary intervention (PPCI) patients who were pretreated with 600 mg clopidogrel. We sought to investigate the short-and long-term efficacy and safety of the periprocedural administration of tirofiban in a largest Serbian PPCI centre. Methods: We analysed 2995 consecutive PPCI patients enrolled in the Clinical Center of Serbia STEMI Register, between February 2007 and March 2012. All patients were pretreated with 600 mg clopidogrel and 300 mg aspirin. Major adverse cardiovascular events, comprising all-cause death, nonfatal infarction, nonfatal stroke, and ischaemia-driven target vessel revascularization, was the primary efficacy end point. TIMI major bleeding was the key safety end point. Results: Analyses drawn from the propensity-matched sample showed improved primary efficacy end point in the tirofiban group at 30-day (OR 0.72, 95% CI 0.53-0.97) and at 1-year (OR 0.74, 95% CI 0.57-0.96) follow up. Moreover, tirofiban group had a significantly lower 30-day all-cause mortality (secondary end point; OR 0.63, 95% CI 0.40-0.90), compared with patients who were not administered tirofiban. At 1 year, a trend towards a lower all-cause mortality was observed in the tirofiban group (OR 0.74, 95% CI 0.53-1.04). No differences were found with respect to the TIMI major bleeding during the follow-up period. Conclusions: Tirofiban administered with PPCI, following 600 mg clopidogrel pretreatment, improved primary efficacy outcome at 30 days and at 1 year follow up without an increase in major bleeding.
Women & Health, 2013
The aim of this descriptive epidemiologic study was to analyze the mortality trends of female bre... more The aim of this descriptive epidemiologic study was to analyze the mortality trends of female breast cancer in Serbia (excluding Kosovo and Metohia) from 1991 to 2010. Average annual percentage of change and the corresponding 95% confidence interval (CI) was computed for trend using linear models assuming a Poisson distribution. The Serbian female population showed an increase in breast cancer mortality continuously from 1991 to 2010 (average annual percentage of change = + 0.9, 95% CI = 0.6-1.1). Breast cancer mortality declined in women aged 30-49 years but increased in women ≥50 years old. Decline in breast cancer mortality in young women was observed during the entire period and was significant in those 35-49 years old. In women 50-54 years old, a significant increase in breast cancer mortality during the period 1991-1997 was followed by significant decrease until 2010. In all older age groups, mortality rates significantly increased during all periods observed. The only exception was among women aged 65-69 years old in whom a small, non-significant decrease in breast cancer mortality was observed in the period 1991-1998, followed by significant increase until 2010. According to a comparability test, breast cancer mortality trends in 30-49, 50-69, and 70+ year age groups differed significantly (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.01).
Transplant International, 1996
Renal Failure, 2008
A comparison of the outcome of hepatitis virus-positive and -negative kidney transplant and hemod... more A comparison of the outcome of hepatitis virus-positive and -negative kidney transplant and hemodialysis patients was the aim of this investigation. The study involved 384 kidney transplant patients (67 HBsAg positive, 39 anti-HCV positive, 278 hepatitis negative), transplanted between 1987 and 2001, and 403 hemodialysis patients (128 HBsAg positive, 83 anti-HCV positive, 192 hepatitis negative) who had started hemodialysis and were referred to the kidney transplant waiting list during the same period. Hemodialysis patients were older than transplant patients. Comparison of the groups&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; survival rates, adjusted for patient age, showed that all kidney transplant patients survived longer than hemodialysis patients (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). HBV infection had a negative impact on patient survival, especially in hemodialysis patients. HCV infection did not have a significant influence on patient survival. Cardiovascular disease was the main cause of death of all hemodialysis- and hepatitis-negative transplant patients. Liver failure was one of the leading causes of death in HBV-positive transplant patients. Mortality risk was higher for older patients, HBV-positive and -negative hemodialysis patients. Kidney transplantation offers longer survival for hepatitis-positive and -negative hemodialysis patients. HBV but not HCV infection had a negative impact on ESRD patient survival.
Pediatric Transplantation, 2007
Living kidney donors represent an important source for organ transplantation worldwide. It has be... more Living kidney donors represent an important source for organ transplantation worldwide. It has been recently reported that their number surpassed that of deceased donors, even in the countries with well-developed deceased kidney transplantation services (1). Living-related kidney transplantation provides many advantages over deceased transplantation, including longer graft and patient survival. In this country, living-related donors still represent the major source of kidneys for transplantation both for adult and for pediatric ESRD patients. In most cases, the kidney donors are the patientsÕ parents. In earlier work, considering outcome and function after kidney transplantation from living donors in adults, we showed that more frequent acute complications and more progressive chronic kidney-graft failure occurred during the first post-transplant year in recipients of grafts from older donors (2, 3). Acute rejection and the difference between donor and recipient age were found to be risk factors for graft loss, while donor age and graft function were risk factors for patient mortality. The living donors of pediatric patients are usually young persons, so their nephron mass is only slightly reduced because of the aging process but the
Journal of Interventional Cardiology, 2013
The present trial aims at examining whether antiplatelet regimen modification, guided by assessme... more The present trial aims at examining whether antiplatelet regimen modification, guided by assessment of the on-treatment platelet reactivity, might result with clinical benefit in moderate to high-risk patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). High platelet reactivity has been associated with an increased rate of ischemic events after PCI. Recent large trials did not show a clinical benefit of platelet reactivity-guided therapy modification in acute coronary syndrome patients treated by PCI. PLATFORM is an investigator-initiated, prospective, randomized, parallel-group, controlled clinical trial. Approximately 632 STEMI patients with intermediate to high-risk (RISK-PCI score &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;3) clinical features undergoing PPCI will be randomly allocated to treatment modification or standard therapy. Low responders to aspirin will receive 200 mg aspirin for 30 days. Low responders to clopidogrel will receive 180 mg ticagrelor for 1 year. The primary end-point is the time to the first composite major adverse cardiovascular events (MACE) including death, nonfatal infarction, stroke, or immediate target vessel revascularization. Key safety end-point is the rate of TIMI major bleeding unrelated to coronary artery bypass graft surgery. Our secondary end-points are individual components of MACE, definite stent thrombosis, total bleeding, and the need for blood transfusions. Patients will be followed-up at 30 days and at 1 year after PPCI. PLATFORM will determine whether the platelet reactivity-guided use of ticagrelor in combination with 200 mg aspirin, compared with standard antiplatelet regimen, improves clinical outcome in moderate to high-risk STEMI patients undergoing PPCI. U.S. National Institutes of Health (NIH) at www.clinicaltrials.gov. ClinicalTrials.gov Identifier: NCT01739556, and Current Controlled Trials at www.controlledtrials.com. International Standard Randomized Controlled Trial Number ISRCTN83081599.
Journal of Computer Assisted Tomography, 2005
In this study, the focus is on midbrain magnetic resonance imaging morphometric measures (transve... more In this study, the focus is on midbrain magnetic resonance imaging morphometric measures (transverse diameter of the midbrain peduncle [Tp], transverse diameter of the tegmentum, anteroposterior diameter of the midbrain, interpeduncular distance [IPD], and interpeduncular angle [IPA]) in a group of 47 consecutive patients with neurologic (37 patients) and hepatic (10 patients) forms of Wilson disease (WD). Morphometric measures were significantly different between the group of patients with WD and healthy controls (51 subjects) as well as patients with Parkinson disease (15 patients) and multiple sclerosis (15 patients). Among the studied variables, IPA, Tp, and IPD were particularly useful in differentiating patients from healthy subjects (probability reaching 93%).
International Journal of Cardiology, 2011
Background: Recently, concerns have been raised about a possible lack of sensitivity of biomarker... more Background: Recently, concerns have been raised about a possible lack of sensitivity of biomarkers to detect left ventricular (LV) dysfunction in patients with myopathies. We examined the ability of the N-terminal brain natriuretic peptide (NT-proBNP) to detect LV or right ventricular (RV) dysfunction in patients with lamin A/C (LMNA) gene mutations. Methods: We prospectively measured plasma NT-proBNP in consecutive patients with documented LMNA mutations and age-sex matched controls. All patients underwent standard echocardiography implemented by pulsed tissue-Doppler echocardiography (TDE). Results: Twenty-three patients were included (10 males, mean age 39.2±18.9 years);10 had previous atrial arrhythmias, 8 had been implanted with cardioverter defibrillator for primary prevention of sudden death, 5 patients were of NYHA class II and 18 of NHYA class I. Sinus rhythm was recorded in all. NT-proBNP was increased in LMNA patients versus controls (123±229 versus 26 ±78 pg/ml, p=0.0004); 7 patients had depressed LV and/or RV contractility. Patients with reduced LV or RV contractility had increased mean NT-proBNP (341±1032 pg/ml versus 80±79 pg/ml in patients with normal myocardial contractility, p=0.004). Receiver-operating-characteristics analysis shows that NT-proBNP reliably detected depressed contractility (area under the curve 0.889 [0.697-1.000]). Sensitivity and specificity were 88% and 83% respectively, applying manufacturer's recommended cutoff concentration of 125 pg/ml. Conclusion: NT-proBNP reliably detected the presence of reduced LV/RV contractility in LMNA patients.
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Papers by Jelena Marinković