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Nowadays, children are able to enrich their reality via the Internet. Unfortunately, this may increase their risk of becoming victims of cyberbullying. We analyzed the health characteristics and risk behavior of two cohorts of children in Serbia; those who reported being exposed to cyberbullying and those who did not. The statistical differences and logistic regression models were applied to the data on 3267 students collected from 64 schools participating in the 2017 Serbian Study on health behavior in school-age children (HBSC). Children exposed to cyberbullying reported having the following health problems on a daily basis: headache (18.5%), back pain (19.5%), depression (21.6%), irritability or bad mood (17.7%), nervousness (16.0%), sleep problems (16.1%), and dizziness (21.2%). As for the different types of risk behavior, cigarette smoking ranging from six to nine days ever was the most prevalent (26.9%). It was followed closely by getting drunk more than 10 times ever (24.1%). Compared to non-victims, victims were found to be at a higher risk of perceived back pain (OR = 2.27), depression (OR = 1.43), irritability or bad mood (OR = 2.07), nervousness (OR = 2.23), and dizziness (OR = 2.43) as well as being injured once or twice (OR = 1.98) or three or more times (OR = 4.09). Victims were associated with further risk factors: having smoked more than five cigarettes ever in life (OR = 1.73) and having gotten drunk two to three times (OR = 1.71) or four or more times (OR = 1.65). As the number of school-age children using social media continues to rise, we must prioritize educating them about self-help and community resources for addressing related health issues with greater speed and intensity. The findings from Serbia suggest that while children may be aware of their health issues, they may be unaware of their link to cyberbullying, which could hinder their ability to address these issues promptly. The respondents' attention to the health implications of cyberbullying could be increased by reformulating the survey questions used in the HBSC study.

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Pediatric stroke (PS) is an injury caused by the occlusion or rupture of a blood vessel in the central nervous system (CNS) of children, before or after birth. Hemiparesis is the most common motoric deficit associated with PS in children. Therefore, it is important to emphasize that PS is a significant challenge for rehabilitation, especially since the consequences may also appear during the child's growth and development, reducing functional capacity. The plasticity of the child's CNS is an important predecessor of recovery, but disruption of the neural network, specific to an immature brain, can have harmful and potentially devastating consequences. In this review, we summarize the complexity of the consequences associated with PS and the possibilities and role of modern rehabilitation. An analysis of the current literature reveals that Constraint-Induced Movement Therapy, forced-use therapy, repetitive transcranial magnetic stimulation, functional electrical stimulation and robot-assisted therapy have demonstrated at least partial improvements in motor domains related to hemiparesis or hemiplegia caused by PS, but they are supported with different levels of evidence. Due to the lack of randomized controlled studies, the optimal rehabilitation treatment is still debatable, and therefore, most recommendations are primarily based on expert consensuses, opinions and an insufficient level of evidence.

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Background and Objectives: The aim of this study was to validate the Serbian version of the Boston Carpal Tunnel Questionnaire (BCTQ) and to evaluate temporal stability for the purpose of its implementation in the evaluation of Serbian patients with carpal tunnel syndrome (CTS). Materials and Methods: For the validation of the Serbian version of the BCTQ (BCTQSR), we tested 69 individuals with diagnosed CTS that were referred for a conservative treatment at the Institute for Rehabilitation. Neurophysiological tests were used for the electrophysiological grading (EG) of CTS severity in the study sample. The final version of the BCTQSR was given to the tested participants from the study on two occasions: test and retest, with a five-day period between the two measurements. Results: The mean value for the symptom severity subscale (SSS) of the BCTQSR was 3.01 ± 0.94; for the functional status subscale (FSS) of the BCTQSR it was 2.85 ± 1.00. Cronbach's α for the SSS was 0.91 and 0.93 for the FSS. The intraclass correlation coefficients (ICCs) concerning the test−retest were significant (p < 0.001) and were 0.949 for the SSS and 0.959 for the FSS. Those with a higher EG grade had higher values of the SSS and FSS but without a statistical significance (p = 0.103 and p = 0.053, respectively). The intercorrelation of the BCTQSR subscales (SSS and FSS) on the test was significant (p < 0.001) with a correlation coefficient equal to 0.777. Conclusion: The Serbian version of the BCTQ (BCTQSR) was successfully culturally adopted. The BCTQSR was a valid and reliable instrument for the measurement of symptom severity and functional status in adults with CTS. Therefore, it can be used in clinical practice for patients with CTS.

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The aim of this study was to examine the prevalence and association of school-age children's participation in bullying, focusing on their health characteristics, risk factors, and leisure activities. We performed a secondary analysis of the original data of the 2017 HBSC study to examine participation in bullying once and multiple times among school-age children in Serbia. For this purpose, a nationally representative sample of 3267 children from 64 primary and high schools in the Republic of Serbia was evaluated. The outcome variable of interest in our study was participation in bullying. Further groups of individual variables such as health characteristics, risk factors, and leisure activities were assessed. Multivariate regression analysis indicated that children who felt everyday stomach pain, irritability or bad mood, and nervousness were more likely to participate in bullying at least once compared with those who rarely or never had such symptoms by 1.46, 1.58, and 1.58 times, respectively. School-age children who reported being drunk two to three times, and four or more times in life were more likely to participate in bullying than those who reported never being drunk by 1.53 and 1.74 times, respectively. Children who reported to watch TV or other media for five or more hours per day were 2.34 times more likely to be involved in bullying at least once. Multiple regression analysis showed that students with daily stomach pain, back pain, nervousness, and dizziness were more likely to be involved in multiple bullying by 1.16, 1.62, 1.82, and 1.70 times, respectively. Students who had nightly meetings or reported being drunk four or more times in the last 30 days were more likely to be involved in multiple bullying by 2.54 and 3.47, respectively. Students who reported playing games five or more times per day were 2.70 times more likely to be involved in this multiple bullying. This study highlights the importance of professional and family education programmes for early identification of specific health symptoms in the pediatric population, as well as integration with interventions aimed at reducing alcohol abuse among school-age children.

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Background and objectives: The purpose of this study is to investigate the differences in the degree of the anxiety and comorbidity levels in patients with different chronic pulmonary diseases such as chronic obstructive bronchitis (COPD) without emphysema phenotype, pulmonary emphysema, bronchial asthma and lung cancer. Materials and Methods: The prospective clinical study included 272 patients that were diagnosed and treated of pulmonary pathology. COPD (without emphysema phenotype) (Group-1), pulmonary emphysema (Group-2), bronchial asthma (Group-3) and lung cancer (Group-4) were assessed. For the evaluation of the anxiety degree, we used Hamilton Anxiety Rating Scale (HAM-A). Results: The degree of cardiovascular symptoms was significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p = 0.001) and Group-4 (p = 0.013), and significantly higher in Group-4 versus Group-2 (p = 0.046). The degree of respiratory symptoms was significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p < 0.001) and Group-4 (p = 0.002), and significantly higher in Group-4 versus Group-2 (p = 0.013) and versus Group-3 (p = 0.023). For gastrointestinal symptoms, the degree of one was significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p < 0.001) and Group-4 (p = 0.017). Somatic subscale values were significantly higher in Group-1 versus Group-2 (p < 0.001), Group-3 (p < 0.001) and Group-4 (p = 0.015), and significantly higher in Group-4 versus Group-2 (p = 0.024). Total HAM-A score was significantly higher in Group-1 versus Group-2 (p = 0.002) and Group-3 (p = 0.007). Conclusions: Patients with COPD (without emphysema phenotype) followed by the lung cancer are at elevated risk of being more mentally challenged in terms of increased anxiety. Furthermore, patients with exacerbation of evaluated pulmonary pathologies have various levels of comorbidities degrees.

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Strokes within pediatric populations are considered to be the 10th leading cause of death in the United States of America, with over half of such events occurring in children younger than one year of life. The multifactorial etiopathology that has an influence on stroke development and occurrence signify the importance of the timely recognition of both modifiable and non-modifiable factors for adequate diagnostic and treatment approaches. The early recognition of a stroke and stroke risk in children has the potential to advance the application of neuroprotective, thrombolytic, and antithrombotic interventions and rehabilitation strategies to the earliest possible timepoints after the onset of a stroke, improving the outcomes and quality of life for affected children and their families. The recent development of molecular genetic methods has greatly facilitated the analysis and diagnosis of single-gene disorders. In this review, the most significant single gene disorders associated with pediatric stroke are presented, along with specific therapeutic options whenever they exist. Besides monogenic disorders that may present with stroke as a first symptom, genetic polymorphisms may contribute to the risk of pediatric and perinatal stroke. The most frequently studied genetic risk factors are several common polymorphisms in genes associated with thrombophilia; these genes code for proteins that are part of the coagulation cascade, fibrolysis, homocystein metabolism, lipid metabolism, or platelets. Single polymorphism frequencies may not be sufficient to completely explain the stroke causality and an analysis of several genotype combinations is a more promising approach. The recent steps forward in our understanding of the disorders underlying strokes has given us a next generation of therapeutics and therapeutic targets by which to improve stroke survival, protect or rebuild neuronal connections in the brain, and enhance neural function. Advances in DNA sequencing and the development of new tools to correct human gene mutations have brought genetic analysis and gene therapy into the focus of investigations for new therapeutic options for stroke patients.

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The study aim was to evaluate the effects of presence and level of musculoskeletal impairment along with gender on physical functioning outcome after the rehabilitation program in aged adults with a hip fracture. We analyzed 203 elderly people with hip fractures above 65 years of age that were treated after the hip surgery. According to the time of examination, patients were tested three times: at admission, discharge, and at three months post-discharge. Musculoskeletal impairments were analyzed, and for the estimation of severity of degree impairment, we used a cumulative index rating scale for geriatrics (CIRS-G). Regarding the gender, we separately analyzed males and females. To evaluate physical functioning of aged adults after a hip fracture, we used the physical functioning component (PFC) from the quality of life (SF-36) questionnaire. For males, on all three occasions we found non-significant differences were found in SF-36 PFC values between different degrees of CIRS-G musculoskeletal impairment. A significant difference was noticed in females three months post-discharge. Effects size of different examination periods for every CIRS-G severity degree of musculoskeletal impairment were high, where males had higher values for severity degrees 1 and 2, and females had higher values for severity degrees 0 and 3. Our findings might suggest that there is a certain degree of different rehabilitation treatment effects for males versus females. Moreover, it might be assumed that other factors could influence different degrees of functional improvement and outcome of individuals after a hip fracture with musculoskeletal impairment.

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OBJECTIVES: The aim of our study was to evaluate the association of health factors with the presence and different degrees of pain in elderly above 65 years of life. METHODS: The population-based study included 3540 individuals above 65 years of age of life from twofold stratified household sample representative for Serbia, during 2013 (the average age 73.9 ± 6.3 years; average Body Mass Index was 26.7 ± 4.4, females 56.8%, living with partner 55.5%, with primary education 55.3%, with poor wealth index 55.8% and from rural settings 46.2%). As health predictors of pain, we analyzed further health parameters: self-perceived general health, long-lasting health problems, diagnosed pulmonary disease, cardiovascular disease, musculoskeletal disease, diabetes, hyperlipidemia, hypertension and other chronic diseases. Pain domain of SF-36 version 2.0 was used for pain assessment. RESULTS: Significant health predictors of pain were: self-perceived general health (OR 2.28), where bad perception of self-perceived general health in our study had greater risk of pain with higher degree of severity; long-lasting health problems (OR 1.60), where elderly with long-lasting health problems had almost twice the risk of moderate degree of pain, and above twice the risk for severe degree of pain; pulmonary disease (OR 1.38); musculoskeletal disease (OR 2.98) and other chronic diseases (OR 1.71). The presence of musculoskeletal disease increases the risk for pain, even more than double in severe versus mild degrees of pain. CONCLUSION: Bad self-perceived general health, long-lasting health problems, pulmonary, musculoskeletal diseases, cardiovascular disease and other chronic disease were significant health-related predictors of various degrees of pain in elderly.

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ABSTRACT Objective: To analyze the impact of rehabilitation treatment on social functioning in elderly patients after hip fracture during a rehabilitation program. Methods: This study included 203 patients with hip fracture. Four groups were analyzed on rehabilitation: Group 1, at admission, Group 2, at discharge, Group 3, three months after discharge and Group 4, six months after discharge. The analyzed parameters included: musculoskeletal, neurological and cognitive impairments. Impairment severity was graded by cumulative index rating scale for geriatrics (CIRS-G). Evaluation of social functioning was completed by social functioning component (SFC) from quality of life (SF-36) questionnaire. Results: There was a significant improvement in SF-36 SFC values for observed impairments from admission to six months after discharge for each severity degree (p<0.01), except for CIRS-G severity degree 4 for cognitive impairment, where significance was p<0.05. For the group of patients with musculoskeletal impairment, there was a significant difference between the values of SF-36 SFC concerning different severity degrees of CIRS-G only at six months after discharge (p<0.05). Patients with neurological or cognitive impairments have shown significant differences between the values of SF-36 SFC in regard to severity degrees of CIRS-G in all observational groups. Conclusion: Different degrees of observed impairments influence the degree of social functioning recovery in the elderly after hip fracture. Level of Evidence II, Prognostic Studies .

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OBJECTIVE: To analyze the impact of rehabilitation treatment on social functioning in elderly patients after hip fracture during a rehabilitation program. METHODS: This study included 203 patients with hip fracture. Four groups were analyzed on rehabilitation: Group 1, at admission, Group 2, at discharge, Group 3, three months after discharge and Group 4, six months after discharge. The analyzed parameters included: musculoskeletal, neurological and cognitive impairments. Impairment severity was graded by cumulative index rating scale for geriatrics (CIRS-G). Evaluation of social functioning was completed by social functioning component (SFC) from quality of life (SF-36) questionnaire. RESULTS: There was a significant improvement in SF-36 SFC values for observed impairments from admission to six months after discharge for each severity degree (p<0.01), except for CIRS-G severity degree 4 for cognitive impairment, where significance was p<0.05. For the group of patients with musculoskeletal impairment, there was a significant difference between the values of SF-36 SFC concerning different severity degrees of CIRS-G only at six months after discharge (p<0.05). Patients with neurological or cognitive impairments have shown significant differences between the values of SF-36 SFC in regard to severity degrees of CIRS-G in all observational groups. CONCLUSION: Different degrees of observed impairments influence the degree of social functioning recovery in the elderly after hip fracture.Level of Evidence II, Prognostic Studies .

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The aim of our study was to evaluate the changes of median nerve conduction velocities by electrodiagnostic procedure in carpal tunnel syndrome (CTS) patients with and without present subjective and physical findings. We have evaluated 116 patients that were diagnosis with CTS. Subjective findings: weakness, numbness and night pain were analyzed. Further physical findings were evaluated: Tinels sign, muscles hypotrophy and weakness according to muscle manual test (MMT). Duration of complaints was evaluated as well. Electroneurographic findings included: estimation of median nerve motor terminal latency (mMTL), sensory velocity (mSV) and motor velocity (mMV). Significantly longer complaints were present in patients who experienced night pain (p=0.015) and those with muscles weakness on MMT (p=0.016). Statistically significant increase for mMTL values was noticed for patients with Tinels sign (p=0.045), present muscles hypotrophy (p=0.001) and weakness on MMT (p=0.001). There is significant decrease for mMV in group with present Tinels sign (p=0.048), muscle hypotrophy (p=0.003) and weakness on MMT (p=0.002), and for mSV in group with present muscle hypotrophy (p=0.008) and group with weakness on MMT (p=0.019). Multivariate logistic regressional analysis shown that only for hypotrophy, mMTL variable presents significant independent contributor (p=0.009). For the diagnosis confirmation and treatment planning along with elecroneurography it is necessary to evaluate patients with CTS clinically, since different clinical manifestations are correlating in different degree with electroneurographic findings.

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With an increased life expectancy in humans and thus an increase in the number of the elderly population, the frequency of hip fractures will rise as well. Aside from a higher incidence, hip fractures in a geriatric population is a significant problem due to the possible onset of severe and in some cases dramatic complications and consequences. The primary purpose of treatment and rehabilitation in the elderly after a hip fracture is to improve an individual's quality of life. It is important to underline that principles and methods of functional restoration after hip fracture should consider careful planning of a rehabilitation program individually for every patient and its implementation with respect to decisions made by the rehabilitation team.

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OBJECTIVE: This study investigated the short-term efficacy of low-level laser therapy (LLLT) in patients with mild to moderate carpal tunnel syndrome (CTS), lasting for <1 year. METHODS: Seventy-nine patients with CTS were included in this double-blind, placebo-controlled study, and randomly divided in two treatment groups: Experimental group (EG), active laser group (40 patients); and control group (CG), placebo (sham) laser group (39 patients). A GaAlAs diode laser [780 nm, 30 mW continuous wave (CW), 0.785 cm(2), 38.2 mW/cm(2)] was applied in contact with four points perpendicularly to the skin over the carpal tunnel area for 90 sec per point (2.7 J, 3.4 J/cm(2)/point). Both groups were treated five times per week, once a day over 2 weeks, followed by 10 treatments every other day for 3 weeks, that is, for a total of 20 treatments. Clinical assessment, including visual analogue scale (VAS) pain rating, Tinel's sign, and median nerve conduction studies (NCSs) were evaluated before, and 3 weeks after, the last LLLT treatment. RESULTS: Significant reduction in pain, reduction in the percentage of patients with a positive Tinel's sign, and shortening of sensory and motor latency time in the NCS examination was observed in the experimental LLLT group (but not in the control group). CONCLUSIONS: This study has observed and documented the statistically significant short-term effects of LLLT on CTS patients in comparison with a placebo group. The results support this conclusion, especially if the LLLT is applied in the earlier stages of CTS, and with mild to moderate cases.

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INTRODUCTION: The aim of the study was to evaluate motor functional status measured by motor Functional Independence Measure (mFIM) test in population above 65 years of age after the hip fracture. MATERIAL AND METHODS: We evaluated 203 patients after hip fracture by mFIM test on 3 occasions: at admission (Period-1), at discharge (Period-2) and 3 months after discharge (Period-3); 3 age groups: Group(65-74), Group(75-84) and Group(85-up) and 2 groups concerning Severity Index (SI): group 0-1.99 (SI1) and group ≥ 2 (SI2). RESULTS: In same SI group there is significant increase in mFIM values for Period-2 and Period-3 for both genders and in first two age groups, while for those above 85 years of age with higher SI we found non-significant change in mFIM values between discharge and 3 months post discharge period. DISCUSSION: The most significant improvement is obtained for women in first and third age groups and with higher SI. CONCLUSION: Gender is not significant predictor for motor functional recovery measured by mFIM test in patients with hip fracture, although the admittance mFIM is a good indicator for mFIM capacity recovery in women of certain age groups (first and third age groups).

Introdução: o objectivo do estudo é a avaliação do nível de independência funcional através da aplicação da escala de Medida da Independência Funcional (Functional Independence Measure [FIM]) em doentes com idade superior a 65 anos, após fractura da anca.Material e Métodos: Foram estudados 203 doentes após fractura da anca, aplicando a escala MIF em 3 momentos: admissão do doente no hospital (Período 1), no momento da alta (Período 2) e 3 meses após a alta (Período 3); os doentes foram englobados em 3 grupos etários: Grupo65-74 , Grupo75-84 e Grupo+85 e em dois grupos, consoante o Índice de Gravidade (IG): grupo 0-1,99 (IG1) e grupo ≥ 2 (IG2).Resultados: No grupo de doentes com idêntico IG, observou-se um aumento dos valores da MIF no Período 2 e 3 em ambos osgéneros e nas primeiras duas classes etárias, ao passo que em doentes acima dos 85 anos, com IG mais elevado, observámos uma variação não significativa dos valores da MIF entre o momento da alta hospitalar e 3 meses após a alta.Discussão: A melhoria mais significativa da MIF foi obtida em doentes do sexo feminino no primeiro e terceiro grupos etários e com IG mais elevado.Conclusão: O género não constitui um factor preditivo significativo da recuperação da independência funcional medida através da aplicação da escala MIF em doentes com fractura da anca, embora a MIF no momento da admissão seja um bom indicador de recuperação funcional em doentes do sexo feminino em certos grupos etários (primeiro e terceiro grupos etários).

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The importance of early inclusion in rehabilitation program and exercise of older people after the hip fracture could be explained by the fact that physical activity influences the muscle strength, balance and eventually degree of hip pain [11]. Such determinants are very important particularly for individuals quality of life and could prevent further risks of comorbidities and falls later in life. It has been often hypothesized that the success of recovery is extremely dependent on the timeliness and adequacy of the treatment. While it is desirable to provide the best possible care as soon as possible the actual limitations that may exist in health-care systems due to a limited number of medical staff as well as limited capacity in rehabilitation programs may create need for appropriate planning and/or scheduling.

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AIM: To evaluate the functional status measured by Berg Balance Scale (BBS) in elderly aged more than 65 years after hip fractures, and to evaluate the influence of sex, age and comorbidity on balance function improvement. METHODS: The study included 203 patients with hip fractures. Functional status was evaluated by BBS: at admission (Group 1), at discharge (Group 2) and 3 months after discharge (Group 3). We analyzed three age groups: Group 65-74 , Group 75-84 and Group 85-up; female and male sex separately; and for severity index value (SI; total cumulative illness rating scale for geriatrics score divided by number of endorsed categories): group between 0-1.99 (SI1 ) and group ≥ 2 (SI2 ). RESULTS: BBS values significantly declined in all male groups and female Group 2 and Group 3 in SI2 (P < 0.01). Group 65-74 and Group 85-up had a significant BBS values decline in Group 2 and Group 3, whereas Group 75-84 had a significant decline in all groups in the SI2 group (P < 0.01). Females and males had a significant BBS values increase in the SI1 groups (P < 0.01), and non-significant BBS values increase between Group 2/Group 3 for SI2 . Group85-up had a significant BBS values increase in SI1 (Group 1/Group 2 and Group 1/Group 3; P < 0.01); a non-significant increase between Group 1/Group 2 and Group 1/Group 3, and a non-significant decline between Group 2/Group 3 in SI2. CONCLUSIONS: Male sex, increased comorbidity and age more than 85 years could be considered with lower functional recovery capacity potential after hip fracture, and thus should be individually assessed and continuously monitored. Functional status estimation by BBS could be taken as a sensitive predictive value for the evaluation of functional improvement in these patients.

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AIM: The purpose of the study was to evaluate the influence of four comorbidities from the Cumulative Illness Rating Scale for Geriatrics (CIRS-G) and their severity on functional status outcome after a rehabilitation program measured by the Berg Balance Scale (BBS) in patients with hip fracture. METHODS: The study included 203 patients whose functional status was evaluated by the BBS at admission (Group 1), at discharge (Group 2) and 3 months after discharge (Group 3). Further comorbidity parameters from the CIRS-G were assessed: musculoskeletal impairment, neurological, vascular and cognitive impairment. For the evaluation of CIRS-G severity degree we used the range 0-4. RESULTS: At admission there were non-significant differences in mean values of BBS between parameters for the same CIRS-G severity degree. Significant differences between BBS values were noticed in the period after discharge (Group 2((musculoskeletal)); P<0.05, Group 2((neurological and cognitive)); P<0.01) and after 3 months of follow-up (Group 3((musculoskeletal, neurological and cognitive)); P<0.01). Higher effects of CIRS-G severity degree on BBS values in Group 2 and Group 3 for neurological impairment (η(2)(Group2)=29.76 and η(2)(Group3)=28.35) and even higher for cognitive impairment (η(2)(Group2)=34.35 and η(2)(Group3)=40.63) were noticed. CONCLUSION: Increase in CIRS-G severity degree of cognitive and neurological impairment in patients after hip fracture that were included in the rehabilitation program correlates closely with functional status after discharge and after 3 months of follow-up. Rehabilitation of patients after hip fracture should be mandatory for functional recovery regardless of the comorbidity and functional status.

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