Introduction. Albumin is a protein produced in the liver, playing a crucial role in maintaining osmotic pressure and transporting molecules. Microalbuminuria, which is the presence of small amounts of albumin in urine, often depicts the damage to kidney function as well as the risk of developing cardiovascular and cerebrovascular diseases. Objective. We aimed to establish the prevalence of microalbuminuria in patients with hypertension and diabetes, and to estimate the prevalence in the difference between these groups and the control group. Method. The study encompassed 139 patients, separated into the exposed group (patients with hypertension and diabetes) and the control group. Microalbuminuria testing was performed using qualitative test strips. These strips detect albumin in urine. For statistical analysis, we used Chi-square - ch2 test to evaluate the difference between the groups. Results. The prevalence of microalbuminuria in the exposed group was 33,09%. Statistically significant difference in the prevalence of microalbuminuria between the exposed and the control group was confirmed with p-values below 0,05. There were no significant differences in distribution according to gender and age. Conclusion. Microalbuminuria was registered in significant percentages in patients with hypertension and diabetes, which necessitates the need for regular screening in order to timely detect changes in kidney function and calculate the risk of cardiovascular diseases.

Introduction. Identifying certain risk factors for osteoporosis can greatly influence its occurrence, progression, and overall outcomes. Objective. Our research focused on osteoporosis and its risk factors in menopausal women attending a general practitioner's office. Method. The research was conducted at the Primary Healthcare Center in Lazarevac from September to December 2016. We collected data on risk factors for osteoporosis during regular visits to general practitioners (GPs) and also utilized medical records. Participants who had one or more risk factors were referred for bone mineral density (BMD) measurement using DEXA scans. Based on the BMD findings and the identified risk factors, some participants were referred to a rheumatologist. Data were analyzed using descriptive statistics and statistical hypothesis testing methods in SPSS version 20. Results. A total of 58 postmenopausal women over the age of 45 participated in our research, with an average age of 65.62 years. The most common risk factors identified were early menopause (32.8%), cigarette smoking (31.0%), and the presence of chronic diseases (25.9%). Among the participants, 51.7% had one or two risk factors, while 22.4% had three or more. Additionally, 72.4% of the participants were referred for DEXA scans, and osteoporosis was diagnosed in 35.7% of them, leading to the initiation of treatment. Conclusion. Identifying individuals at risk for osteoporosis in a general practitioner's office can be done easily by looking for specific risk factors. Early health interventions can lead to effective prevention, prompt diagnosis, and appropriate treatment of the disease.

Introduction. Breast cancer is the most prevalent cancer in women. The most reliable method to diagnose breast cancer is through mammography, combined with ultrasonography or magnetic resonance imaging. The treatment plan may include surgery, radiation therapy, chemotherapy, hormone therapy, targeted therapy, or immunotherapy. Case report. The following is a case report of a 46-yearold woman who visited a physician in 2007 when she was planning her second pregnancy. She was 30 years old at the time. During a routine breast self-examination, she noticed a lump and was sent for an ultrasound examination where the tumor was confirmed. After diagnosis and preoperative preparation, she underwent breast-preserving surgery of the left breast, along with axilla dissection due to positive lymph nodes. Pathohistologic findings confirmed Carcinoma mixtus praecipue ductale G2 et partim mucinosum G2, while no metastatic changes were found in the axillary lymph nodes. The tumor's hormonal status was estrogen 1, progesterone 1, and HER2 2. The patient received six rounds of FAC chemotherapy followed by 16 rounds of trastuzumab. After starting on tamoxifen and using it until December 2009, she had to undergo the removal of her right ovary due to the discovery of numerous cysts. Several cysts were also found on the left ovary. Five years after her breast cancer surgery, the patient became pregnant and gave birth to a baby girl. She breastfed her for ten months from the breast that was not operated on. Conclusion. Breast cancer is a serious illness that can greatly affect the reproductive health of young women. It is essential to take into account the patient's desire to have children after treatment. Therefore, it is crucial to provide appropriate therapy and counseling.

Introduction. There are approximately 17.000 new cases of diabetes mellitus type 2 (DM2) in Serbia each year. A third of the newly diagnosed already has some late disease complications and almost half of them are over 65. Objective. We aimed at determining the level and risk factors for DM2 in respondents of different gender, age, and lifestyle in the Municipality of Golubac. Method. The study was conducted using the DM2 questionnaire. The sample had 404 participants who were screened in the Municipality of Golubac. Significant statisti-cal methods were used in the study: frequency, t-test, ANOVA test, and correlation analysis. Results. The study showed the majority of participants (40.1%) had slightly elevated risk for DM2, high risk was found in 14.9%, and very high risk in 3.2%. Moderate risk was found in 27.5% of the participants and 14.4% had low risk. Women had a higher percentage of high and very high risk for DM2 than men but no statistically significant difference was found between men and women concerning the risk of developing the disease. With age, as well as obesity, the risk for DM2 increases. The participants who practiced regular physical activity, as well as those who regularly consumed fruits and vegetables, had a lower risk for DM2. Conclusion. The study showed almost every fifth participant had a high or very high risk for DM2, 81.7% were overweight, and 75% had previously diagnosed cardiovascular problems. Registration of persons with an elevated risk for DM2 and further follow-up is a very important task for GPs (general practitioners).

Introduction: Social skills inventory is a measure used to evaluate two dimensions of communicational skills: emotional (non-verbal), and social (verbal). Each dimension evaluates three categories: expressiveness, sensibility, and control. Objective: We wanted to find out if there was a statistically significant difference in social skills, in health workers, in the city of Loznica. We hypothesized there weren't any differences in social skills inventories of men and women working in primary and secondary healthcare levels. Method: The participants were given the SSI (Social skills inventory) questionnaire. It contained 90 questions, divided into 6 categories. The total number of the participants (employees of the primary and secondary health care institutions in the city of Loznica) was 76, of whom 51 were women and 25 men, and their age ranged from 25 to 65. A university level of education had 47 participants, 4 had a college degree, and 25 had a high school degree. The inferential statistics (t-test) was used for data analysis. Results: After data analysis, based on statistical data handling (t-test of independent categories for singular samples) we got a p<0.05 for expressiveness, and it was more prominent in male participants and behavioral control in female participants. The p-value for the total score for social skills was p>0.05, which bore no statistical significance. There was no statistically significant difference in the total score of the inventory of social skills between male and female health care workers. Though, there was a statistically significant gender difference in expressiveness, in favor of men, and social control, in favor of women. Conclusion: The total score, after testing the inventory of social skills of health workers in Loznica, showed there was no statistically significant difference between men and women, but the level of expressiveness and behavioral control showed a statistically significant difference.

Introduction. Eosinophilic esophagitis (EoE) represents chronic, a local immune-mediated disease with symptoms of esophageal dysfunction and histologically eosinophil-predominant inflammation and requires immediate endoscopy. Male gender is a strong risk factor. Case report. We presented a case of a 25-year-old young man with a history of allergic rhino-conjunctivitis, asthma, and intermittent severe feeding disturbance. The patient had begun sublingual immunotherapy therapy, containing specific soluble allergens for ambrosia. Six weeks after starting the ambrosia sublingual immunotherapy he developed burning epigastric pain, dysphagia, and odynophagia. Six days later, he was admitted to an emergency department due to choking on a solid of food. Esophageal histopathological findings were in favor of EoE. Sublingual immunotherapy was discontinued. He feels well now. Conclusion. The majority of cases of Eosinophilic esophagitis are diagnosed in spring or fall, 1-2 months following the peak of pollen season. Dysphagia, chest pain, food sticking, and bolus obstruction are the most common symptoms. Endoscopic findings are Schatzki ring, edema, exudates, furrows, and strictures. Six biopsies should be taken from areas with endoscopic mucosal abnormalities, and infiltration of eosinophils (more than 15 eosinophils/HRI) (HRI - high resolution imaging) is necessary for the diagnosis confirmation. Treatment options are proton pump inhibitors - oral dispersible tablets of budesonide or fluticasone propionate, an elimination diet. Sublingual immunotherapy should be discontinued. Family physicians should be aware of this complication in evaluating patients with dysphagia.

Introduction: The most common mental disorders in the elderly are depression and dementia. Objective: Examine the impact of sociodemographic characteristics on the appearance of depression and dementia in elder patients treated in Primary Health Center (PHC), Banja Luka. Method: The study included 208 patients over 65 years of age, selected by random selection method, registered in 6 family medicine teams at the PHC Banja Luka in the period from March to May 2016. Respondents completed the Sociodemographic Questionnaire, Beck's Depression Inventory, and Folstein Mini-Mental State Examination (MMSE) for dementia assessment. Different statistical procedures were used in the data processing: descriptive analysis in the form of frequencies and percentages, Chi-square test, T-test. The results of the research were statistically analyzed by SPSS 11.5 program. Results: The study included 208 patients older than 65, of whom 38.9% were male. Impaired cognition was found in 7.2% and moderate depression in 24.5% of patients. Dementia was statistically significantly (p = 0.000) more present in the eldest respondents ≥ 81 years, while depression was mostly present in patients aged 76-80. Physically active individuals were significantly less affected by depression (p = 0.001) and dementia (p = 0.000). Dementia and depression occurred more frequently in people living alone and people with a low level of education. Conclusion: A family physician plays an important role in the early detection of depression and dementia in the elderly, the identification of risk factors, prevention, and treatment of these patients.

Uvod. Pojedinci sa normalnom telesnom težinom

Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic disease and it is estimated 20%-25% of patients remain undiagnosed. Objective: Review the approach of the general practitioner to diagnosing and treatment of COPD. Method: The study was conducted using the questionnaire, among the doctors who attended the Conference “General Medicine Days” that took place in Belgrade, from March 25th to March 26th, 2017. Data on age, gender, years of service, job location (town/village) and specialties: general practitioner (GP) or General Medicine Specialist (GMS) were obtained. Statistical processing was done in the SPSS 11.0 for Windows program. Results: The study included 330 physicians of both genders (88.68% women), average age 49.74 ± 10.5 years and years of service of 21.23 ± 10.55 years; 53.94% were GMS, and 87.27% of doctors worked in outpatient clinics in the city. The definition of COPD was knowledgeable to 74.85% of the participants and the clinical symptoms were recognized by 64.12% of the examined doctors. GPs gave more accurate answers than GMS (p=0.04), as well as doctors with up to 10 years of services (p=0.04), 81.46%, confirmed that bronco obstruction should be confirmed with spirometry, more doctors with up to 10 years of service (p=0.01). 46.38% of the examined doctors think spirometry could be performed at the PHC level. The spirometry finding are interpreted correctly by 61.7% of doctors. The pulmonary oximeter device owns 29.43% of doctors in their clinics, more often GPs (p=0.02) and doctors working in the rural clinics (p=0.02). 56% of doctors have an inhaler and use it regularly, more often doctors in rural outpatient clinics (p=0.02). For 56.56% of doctors, smoking cessation is the first step in COPD treatment. 78.12% think the therapy should be increased stepwise, and 55.32% of them self-initiated bronchodilator therapy (more often doctors with a years of practice of over 20 years, p=0.01). Conclusion: It is necessary to change the doctors' attitude in general practice towards COPD and to improve knowledge about diagnostics and therapy.

Introduction: Diabetic foot syndrome, with ulcers, gangrene development and consequent amputation, represents a chronic complication of diabetes mellitus. Because of the high incidence it significantly contributes to the overall morbidity, disability and mortality of the patients suffering from diabetes. Patient's quality of life, already low with preexisting chronic complications of diabetes, extremly deteriorates with development of gangrene. Treatment is complex and prolonged. Objective: Case presentation of gangrene treatment in a 73 year old female patient with diabetes, on insulin therapy. The treatment included thioctic (alpha lipoic) acid containing medication, antibiotics, peripheral vasodilators, double lay­ered silicone polyurethane wound dressings for bandaging of gangrenous wound on the patient's right foot. Results: The result of this treatment was regression, healing and epithelialization of the gangrenous wound of the foot. Discussion: Diabetic foot is a chronic complication of diabetes mellitus which is frequently encountered by general practitioners and often is treated in primary health care. The appearance of ulcerations and gangrene makes treatment more complex, demanding regular surgical debridement procedures of the wound, and treatment of infection with wide spectrum antibiotics. Patients with pre-developed gangrene of the foot achieve faster healing and epithelialization of the gangrenous wound by using double layered silicone polyurethane wound dressing and medicamentous therapy, instead of classic wound dressing. Conclusion: A faster healing of the gangrenous wound is achieved by using double layered silicone polyurethane wound dressing and medical treatment with medicaments containing alpha lipoic acid, peripheral vasodilators and wide spec­trum antibiotics. Early diagnosis of diabetes mellitus with adequate and prompt treatment of the disease and its complications as well as patients education, reduces the risk of gangrene as the most serious manifestation of the diabetic foot condition with amputation as a consequence.