Milan Bjekic - Academia.edu (original) (raw)
Papers by Milan Bjekic
Serbian Journal of Dermatology and Venereology, Mar 1, 2015
Majocchi's granuloma was fi rst described by Domenico Majocchi in 1883, as a deep chronic dermato... more Majocchi's granuloma was fi rst described by Domenico Majocchi in 1883, as a deep chronic dermatophyte infection of hair follicles, in which dermatophytes penetrate the dermis through hair canals, forming granulomatous changes in the dermis and/or hypodermis. Majocchi's granuloma has two different clinical variants: the fi rst is a small perifollicular papular type, seen in otherwise healthy individuals, that occurs secondary to trauma (e.g. in women with chronic tinea pedis that extends to the legs and who shave their legs); the second is a type with deep plaques or nodular lesions in immunocompromised hosts. The diagnosis is primarily made using direct microscopy of unstained specimens and fungal cultures, while additional diagnostics (histology, PCR) are generally not necessary. It is most commonly caused by Trichophyton rubrum. We present a 26-year-old otherwise healthy man exhibiting blue erythematous patches over the skin of his abdomen on clinical examination, which agglomerated to form slightly raised plaques with irregular ovoid contours, spreading from umbilicus to the pubic region; they were covered with multiple red-blue, erythematous partly coalescing scales, eroded, fi rm papules and nodules. On pressure, some nodules excreted viscid and turbid sero-purulent content. The lesions were slightly itchy. The patient was previously unsuccessfully treated during at least 4 weeks with a topical steroid cream prescribed by his physician. Direct microscopy for fungi of skin scrapings and pus mounted in potassium hydroxide was negative. Cultures of the contents and scrapings were performed on Sabouraud's glucose agar and Trichophyton rubrum was isolated. The diagnosis of Majocchi's granuloma was made, and the patient was treated with itraconazole (200 mg daily) for eight weeks, when all lesions resolved and fungal culture was negative. Misapplication of topical corticosteroids over a long period, as in our case, can produce Majocchi's granuloma. When assessing skin lesions of unusual appearance, especially if aggravated by corticosteroids, dermatologists and general practitioners should consider tinea incognito, which may appear in its invasive form of Majocchi's granuloma. The available world literature shows that Majocchi's granuloma presenting as tinea incognito caused by topical corticosteroids has been reported extremely rarely.
Serbian Journal of Dermatology and Venereology, Dec 1, 2013
Case reports Case 1 A 28-year-old man presented with folliculitis unrelated to artificial penile ... more Case reports Case 1 A 28-year-old man presented with folliculitis unrelated to artificial penile nodules. Physical examination accidentally revealed 5 asymptomatic penile nodules, four of them on dorsal part of the penis and one at the prepuce edge (Figure 1). Careful personal history gave insight into the etiology of nodules. These were capsule shaped artificial self-implanted plastic pearls, inserted two years ago by piercing the penile skin with a sharp iron rod, without a local anesthetic. The beads were made from a toothbrush by using sandpaper. The patient was in prison at that time, and suffered no serious side effects after insertion. The aim was to enhance the patient's sexual pleasure and the pleasure of his sexual partners.
PubMed, Apr 26, 2001
Introduction: Sexually transmitted diseases (STDs) comprise a large group of infections caused by... more Introduction: Sexually transmitted diseases (STDs) comprise a large group of infections caused by different microorganisms including spirochetes, bacteria, chlamydia, mycoplasma, protozoa, fungi, parasites, and viruses. A considerable number of patients with sexually transmitted diseases are STD recurrences. As reported by Marijanović and Lalosević, in Belgrade, among patients who visited the City Department of Skin and Venereal Diseases, during 1985 and 1986 because of syphilis or gonorrhea, 22.8% had these diseases two or more times during their lives (male/female ratio 10:1). The aim of this study was to test the hypothesis that there is a relationship between alcohol use and recurrence of STD. Material and methods: A case-control study was performed in Belgrade population, from June, 1997 to April, 1998. Participants were recruited among patients attending the City Department of Skin and venereal Diseases of Belgrade because of sexually transmitted diseases (syphilis, gonorrhea, nongonoccocal urethritis and genital warts). The case group comprised 101 patients who already had STD two or more times in their personal histories. The control group consisted of 210 patients treated at the same institution for micotic diseases, patients who either never had STD or had it only once (13% of controls) in their personal histories. All participants were men aged 20 to 50 years and all were from Belgrade. Data on demographic characteristics, sexual history and sexual behavior, and data on antisocial behavior were collected from all participants using an anonymous questionnaire. In the present paper only data on alcohol use are presented. In the analysis of data chi 2-test was used. Results: STD recurrence patients in comparison to their controls used alcohol more frequently (56.3%:16.1%), especially hard liquors, and 55.5% of them used alcohol at the time of STD infection. Discussion: In the present study STD recurrence patients consumed alcohol more frequently than their controls, especially hard liquors. In the study of Myliueva et al, 50% of venereal disease patients consumed alcohol now and then and 10% consumed alcohol frequently. Scheidt and Windle found that 60% of alcoholics had at least one sexually transmitted disease as the result of a high number of sexual partners, low use of condoms and practicing sex for drugs or money. Alcohol has a depressive effect on central nervous system, reduces anxiety and increases libido. Conclusion: The obtained results support the hypothesis that alcohol use is related to recurrence of STDs.
Zdravstvena zaštita, 2019
_______ 15 SAŽETAK Uvod/Cilj: Iako su sifilis i gonoreja prepoznate kao "stare" polne bolesti dan... more _______ 15 SAŽETAK Uvod/Cilj: Iako su sifilis i gonoreja prepoznate kao "stare" polne bolesti danas predstavljaju "nov" problem. Širom sveta opisan je porast obolevanja od sifilisa koji je često praćen HIV infekcijom, a usled pojave rezistencije gonokoka na sve veći broj antibiotika, gonoreja preti da postane neizlečiva bolest. Cilj ovog istraživanja je bio da se utvrde razlike između obolelih od sifilisa i gonoreje u odnosu na njihove demografske karakteristike i ponašanje. Metode: U studiju preseka uključeni su oboleli od sifilisa i gonoreje koji su se tokom 2016. godine lečili u Gradskom zavodu za kožne i venerične bolesti u Beogradu. Rezultati: U studiju je uključeno 278 pacijenta, 140 (50,4%) sa gonorejom i 138 (49,6%) sa sifilisom. U poređenju sa obolelim od gonoreje, pacijenti sa sifilisom su bili stariji, češće muškog pola i višeg obrazovnog statusa, kasnije su stupali u seksualne odnose-posle 20. godine, ređe su imali stalnog partnera, bili su homoseksualne ili biseksualne orijentacije, a tokom poslednjih šest meseci ćešće su praktikovali oralni i analni seks, kao i seks sa osobama iz inostranstva. Oboleli od sifilisa su ređe davali podatak o gonoreji u ličnoj anamnezi, ali su češće bolovali od sifilisa, hepatitisa B i bili su HIV pozitivni. Zaključak: U poređenju sa obolelima od gonoreje pacijenti sa sifilisom su imali promiskuitetnije ponašanje, HIV pozitivan status i pripadali su populaciji muškaraca koji imaju seks sa muškarcima. Ključne reči: sifilis, gonoreja, muškarci koji imaju seks sa muškarcima, HIV SUMMARY Intoduction/Aim: Although syphilis and gonorrhoea are "old" sexually transmitted diseases they have become a "new" problem: syphilis resurgence is noticed worldwide and it is followed by HIV co-infection, while drugresistant gonorrhoea could be potentially untreatable infection. The aim of this study was to identify any differences between syphilis and gonorrhoea cases in regard to their demographic characteristics and behaviour. Methods: In this cross-sectional study, data were collected from consecutive syphilis and gonorrhoea cases registered at the City Institute for Skin and Venereal Diseases in Belgrade in 2016. Results: The study included 278 cases, 140 (50.4%) with gonorrhoea and 138 (49.6%) with syphilis. In comparison with gonorrhoea patients, syphilis patients were older, more frequently males with higher education, had their first sexual intercourse later, at 20+ years of age, less frequently had a permanent sexual partner, were more frequently homosexual or bisexual, and during the last 6 months had more frequently anal sex and oral-anal sex, as well as sex with a foreigner. They also had gonorrhoea in their personal history less frequently, but more frequently syphilis and hepatitis B infection, and they were more frequently HIV positive. Conclusion: In comparison with gonorrhoea cases, patients with syphilis were more frequently men who have sex with men with more pronounced risk behaviour and HIV co-infection.
Zdravstvena zaštita, 2019
_______ 5 SAŽETAK Uvod/Cilj: Indeks bola i oganičene pokretljivosti ramena (SPADI) se preporučuje... more _______ 5 SAŽETAK Uvod/Cilj: Indeks bola i oganičene pokretljivosti ramena (SPADI) se preporučuje i često koristi za merenje trenutnog bola i nesposobnosti u ambulantnom okruženju. Međutim, validnost i pouzdanost srpskog SPADI upitnika nisu do sada proučavani. Cilj ove studije je bio da se proceni pouzdanost i validnost SPADI upitnika na srpskom jeziku. Metode: Istraživanje je sprovedeno kao panel studija na Institutu za ortopedsko hirurške bolesti "Banjica" (IOHB) u Beogradu. Obuhvaćeno je 33 pacijenata sa sindromom bolnog ramena, koji su bili upućeni na pregled kod lekara na IOHB tokom 2016. i 2017. godine. Srpska verzija SPADI upitnika prevedena je u skladu sa međunarodnim smernicama. Unutrašnja validnost je procenjena određivanjem Cronbach-ovog alfa koeficijenta. Interklasni koeficijent korelacije (ICC) je primenjen za procenu test-retest pouzdanosti. Faktorska analiza je korišćena za ispitivanje konačne strukture upitnika. Rezultati: SPADI upitnik ima odličan nivo unutrašnje konzistentnosti (Cronbach alfa =0,946). Pouzdanost posle ponovonog testiranja SPADI upitnika bila je veoma visoka (ICC =0, 997). Pomoću eksploratorne faktorske analize izdvojen je jedan faktor koji objašnjava 50,1% varijanse. Zaključak: Srpska verzija SPADI upitnika ima visok nivo unutrašnje konzistentnosti i pouzdanosti. Međutim, naši rezultati ukazuju da, iako konceptualno upitnik ima dva domena, naši ispitanici ne prave razliku između bola i ograničenosti pokreta, te se preporučuje samo upotreba ukupnog skora SPADI upitnika.
Serbian Journal of Dermatology and Venereology, Jun 27, 2017
"Contact tracing" or "partner notification" refers to clinicians' efforts to identify sex partner... more "Contact tracing" or "partner notification" refers to clinicians' efforts to identify sex partners of infected persons to ensure their medical evaluation and treatment. For many years partner notification has been a cornerstone in the management of patients diagnosed with sexually transmitted infections (STIs) and it is the essential component in the control of these infections. Clinicians' efforts to ensure the treatment of a patient's sex partners can reduce the risk for re-infection and potentially diminish transmission of STIs. Partner notification includes three different approaches for notifying the sexual partners of the person infected with a STI: provider referral, patient referral, and contract referral. The aim of our study was to evaluate the efficacy of partner notification among syphilis and gonorrhea cases registered at the City Institute for Skin and Venereal Diseases in Belgrade in 2016, and its contribution to prevention and control of these diseases. A retrospective chart review of patients with gonorrhea and early syphilis registered in 2016 was undertaken. We analyzed data about the possible source of infection as well as sexual orientation, provided on the official form for notification of syphilis and gonorrhea. The study included 112 male patients, 67 with gonorrhea and 45 with syphilis. Out of three modalities of partner notification offered to patients, only patient notification of sexual partner/s was accepted. Although all patients accepted this type of partner notification, index patients with gonorrhea notified only 17 partners (25.4%) and index patients with syphilis also notified 17 partners (37.8%). The effectiveness of partner notification for gonorrhea and syphilis cases was only 30.4%, and its contribution to prevention and control of these diseases was lower than we expected. National guidelines offering standardized protocols for partner notification service provision can improve this process, as a novel approach with non-traditional method of partner notification such as patient-delivered partner therapy.
PubMed, Apr 1, 2018
Dear Editor, Proper and consistent use of male condoms can be a highly effective method of preven... more Dear Editor, Proper and consistent use of male condoms can be a highly effective method of preventing the transmission of sexually transmitted infections (STIs) and HIV (1), but this method relies on men's willingness and ability to use condoms. In the United States of America, about 20% overall and less than 50% of adults with multiple partners used a condom at last intercourse (2). In Serbia in 2013 (3), 50.0% of women and 62.5% of men aged 15-49 who had more than one partner in the past year used a condom during their last intercourse. Heterosexual men often use condoms to prevent pregnancy rather than the transmission of venereal diseases (4). For better public promotion of condom use, it is necessary to know the reasons for its inconsistent or incorrect use. With this in mind, we asked 200 consecutive chlamydia-positive heterosexual men admitted to the City Institute for Skin and Venereal Diseases in Belgrade to complete an anonymous questionnaire, taken from a Danish study (5), about their attitudes to/or experience with condoms. Patients were divided into two groups; Group I consisted of 109 (54.5%) men who reported that they had never or sometimes used condoms during intercourse and Group II consisted of 91 (45.5%) men who had used a condom often or always. The majority of participants (68.5%) were ≤30 years old, while the rest were older. The analysis of differences between these two groups was performed using a chi-square test. Attitudes concerning use of condoms are presented in Table 1. The majority of our participants (43.5%) did not use a condom because they had sexual intercourse with regular partners. This may be explained by trust and misperception of risk of contracting STIs during sex with a regular partner or lack of discussion with the partner about condom use. The results of another study about condom use with a steady partner (6) have shown that 31% of participants reported using condoms consistently with steady partners. The second most frequent reason for not using a condom in our participants was the statement that condom decreased sexual pleasure. Several studies (7,8) have reported that this is one of the main reasons for not using a condom. In Randolph et al. (9), both women and men rated unprotected vaginal intercourse as more pleasurable than protected vaginal sex. In particular, men believe that condoms reduce sexual pleasure and they are less likely to use them in practice. Condom-associated erection problems or problems with condom fit were reported by 42% of our participants (items 1, 14, 15 in Table 1). Several studies have shown that men experiencing condom-associated erection problems practiced unprotected vaginal intercourse significantly more frequently than men who did not experience this problem (10,11). Although alcohol use has been found to be an independent and important risk factor for unprotected sex (5,12), only 5.5% of our participants reported that alcohol intake was the main reason for not using a condom. In the present study, participants who had never or sometimes used condoms reported significantly more frequently that they forgot to bring or even use a condom when it was available, which illustrates their risky behavior and unwillingness to use a condom. Patients who had often used a condom reported condom failure significantly more frequently because of their partners refusing to use it. Since men believe more frequently than women that condoms reduce sexual pleasure, the question is whether they could not persuade their partners or find a good excuse not to use it. In summary, the results of the present study indicate the main factors that should be considered when promoting condom use. Such promotion should include advice about using condoms, a demonstration of correct use, and provision of condoms to the patient.
Serbian Journal of Dermatology and Venereology, Dec 20, 2017
Lues maligna is a rare ulcerative form of secondary syphilis. This clinical entity is predominant... more Lues maligna is a rare ulcerative form of secondary syphilis. This clinical entity is predominantly found in patients living with HIV or AIDS. We report a case of a 32-year-old homosexual man with diffuse non-pruritic, papular skin lesions, ulcerated nodules and plaques disseminated on the face, trunk and extremities. The rash was followed by fever, malaise and joint pains. Serological tests for syphilis were positive. The patient was treated with intramuscular penicillin and the lesions resolved completely. Lues maligna was an initial presentation of underlying HIV infection. The HIV seropositivity was confirmed by Western blot analysis. Due to the increased number of syphilis cases and frequent HIV co-infection in Serbia, dermatologists must be able to recognize this condition based on clinical characteristics and risk factors and to diagnose and treat it promptly.
Zdravstvena zaštita, 2021
Early syphilis has been increasing in the Republic of Serbia since 2010 and its infectivity for s... more Early syphilis has been increasing in the Republic of Serbia since 2010 and its infectivity for sexual partners lasts for a year from the moment of infection. The exception is pregnant women who, if left untreated, can transmit the infection to the fetus within four years of infection. Syphilis in pregnancy can cause miscarriage, stillbirth, low birth weight or congenital syphilis. The aim of this paper is to present the clinical manifestations, laboratory diagnostics and therapy of syphilis in pregnancy, as well as to sensitize medical workers to this disease and the introduction of mandatory serological screening tests for syphilis in all pregnant women.
Serbian Journal of Dermatology and Venereology, Sep 1, 2015
European Economic Area, the overall incidence of reported cases was 15.3 per 100.000 people in 20... more European Economic Area, the overall incidence of reported cases was 15.3 per 100.000 people in 2012. Th e highest rates were observed in the United Kingdom (45.4 per 100.000), while low rates (<5 per 100.000) were generally reported in the Central and Eastern Europe. In 2012, there was a low reported incidence of gonorrhea in Serbia (1.49/100.000), as well. Th e purpose of this study was to report on the epidemiology of gonorrhea in Belgrade (about 1.5 million inhabitants) during the period 2010-2014, and to discuss the data in the light of changes in gonorrhea incidence in the European Union.
Zdravstvena zaštita, 2022
Uvod/Cilj: U Beogradu sifilis i infekcija izazvana virusom humane imunodeficijencije (HIV) se naj... more Uvod/Cilj: U Beogradu sifilis i infekcija izazvana virusom humane imunodeficijencije (HIV) se najčešće javljaju među muškarcima koji imaju seksualne odnose sa muškarcima, koji su neretko stigmatizovani i diskriminisani, te se ne usuđuju da rade testiranja na ove bolesti u zdravstvenim ustanovama. Cilj ovog istraživanja je bio da se utvrde prevalencija sifilisa i HIV infekcije među muškarcima koji imaju seksualne odnose sa muškarcima koji su testirani u "check-point" centru udruženja "Potent" u Beogradu. Metode: U ovu studiju preseka uključene su 993 osobe testirane na HIV i 860 osoba testiranih na sifilis brzim skrining testovima HEXAGON SYPHILIS i HEXAGON HIV. Rezultati brzih testova na HIV su potvrđeni pozitivnim Western-Blot testom na Infektivnoj klinici Kliničkog centra Srbije, a na sifilis pozitivnim serološkim testovima (VDRL-Venereal Disease Research Laboratory; laboratorijski test za istraživanje veneričnih bolesti i TPHA-Treponema Pallidum Haemagglutination Assay; Treponema Pallidum hemaglutacioni test) u Gradskom zavodu za kožne i venerične bolesti u Beogradu. U statističkoj analizi podataka korišćene su proporcije, procenti i χ 2 test. Rezultati: Pozitivan test na HIV je zabeležen kod 11 (1,1%), a pozitivan test na sifilis kod 34 ispitanika (3,9%). Najmlađi novootkriveni HIV pozitivni ispitanik imao je 22 godine, a najstariji 46 godina, dok je najmlađa osoba sa pozitivnim testom na sifilis imala 19 godina, a najstarija 68. Zaključak: Strategije testiranja na sifilis i HIV među muškarcima koji imaju seksualne odnose sa muškarcima bi trebalo da budu raznolike uključujući i testiranje u zajednici koje sprovode nevladine organizacije u saradnji sa zdravstvenim ustanovama.
Indian Journal of Dermatology, Venereology and Leprology, Jun 9, 2022
Central European Journal of Public Health, Dec 30, 2017
Objective: A worldwide syphilis incidence increase was recorded at the beginning of the new mille... more Objective: A worldwide syphilis incidence increase was recorded at the beginning of the new millennium, occurring primarily among men who have sex with men (MSM). The aim of this study was to analyse the epidemiological situation of syphilis in the Belgrade population between 2005 and 2014 and to examine the characteristics of an early syphilis outbreak among MSM in Belgrade in 2014. Method: Reporting of syphilis is compulsory in Serbia. Routinely reported data were analysed along with data collected from patients' charts. Results: During the period observed, syphilis incidence increased from 1.07 per 100,000 in 2005 to 4.1 per 100,000 in 2014 (383.2%). From 2005 to 2009, syphilis rates in Belgrade were low, around 1 case per 100,000 people. The first outbreak was registered in 2010. The new incidence increase happened in 2012, and again in 2014 when it was the highest. These incidence changes were registered mainly in men, where the frequency of syphilis was much higher than in women. In 2014, primary syphilis was diagnosed in 20 cases, secondary syphilis in 42, and early latent syphilis in 9 patients. Fifty-seven were MSM, 10 were heterosexual men and 4 were women. Twenty-four cases, all MSM were co-infected with HIV. Majority of patients acquired infection in Belgrade, while in 42/71 cases oral sex was the only risk factor. In comparison with HIV negative, HIV positive syphilis patients were older, more frequently unemployed and MSM. They also more frequently had sex with unknown partners and were diagnosed in the secondary stage of infection. Conclusions: Study results underline the need for coordinated and expeditious surveillance, partner services, enhanced screening of population at risk, health education, as well as early diagnosis and treatment.
Anais Brasileiros De Dermatologia, Nov 1, 2019
Timočki medicinski glasnik, 2020
Introduction: Several studies have shown increasing rates of many sexually transmitted diseases (... more Introduction: Several studies have shown increasing rates of many sexually transmitted diseases (STDs) in the population group aged 50 years and older, worldwide. Older persons usually know less about STDs and HIV/AIDS than younger individuals. The aim of the present study was to reveal why older patients seek venereologists' help and to assess their knowledge of STDs. Material and Methods: Data were collected from consecutive patients aged 60 and over who attended counselling for sexually transmitted diseases at the City Institute for Skin and Venereal Diseases in Belgrade from July to December 2017. One dermatologist examined and interviewed all participants by the use of a questionnaire. Results: Out of all participants (174 patients), 23.56% had some of STIs, 58.62% had some other genital disorders and 17.82 came for counselling. The most frequent viral STDs were acute and recurrent genital warts and recurrent genital herpes, while the most frequent bacterial STD was syphilis. Out of non STDs the most frequent were balanitis, in men, and lichen sclerosis in both sexes. The perceived knowledge mean scores for each STD, ranging from "0", meaning not knowledgeable at all, to "5", meaning very knowledgeable, ranged from 0.63 to 2.71. It was the best for syphilis, followed by gonorrhoea, HIV/AIDS, hepatitis B, genital warts and Chlamydia. Correct answers concerning general knowledge of STDs were given by 59% to 96% of participants. Conclusion: A considerable number of older people who sought venereologists' help had an STD. Their general knowledge of STDs as well as perceived knowledge of single STDs were unsatisfactory and did not differ between patients with and without STDs.
Acta Facultatis Medicae Naissensis, Dec 1, 2018
Penis size is a major body image concern for the majority of men in western nations, while in gay... more Penis size is a major body image concern for the majority of men in western nations, while in gay culture the penis has become a body part linked to sexual attractiveness and viability. The aim of this study was to reveal influence of the perceived penis size on sexual behaviour, condom use, sexually transmitted infections and men's sexual positioning among men who have sex with men. In this cross-sectional study, the data were collected from consecutive men who have sex with men who attended Counselling for Sexually Transmitted Diseases at the City Institute for Skin and Venereal Diseases in Belgrade, Serbia. Out of 319 participants, 6.6% perceived their penis as "below average", 71.5% as "average", and 21.9% as "above average". In comparison with men with an average penis, men with below average penis were more frequently unsatisfied with their penis size (p < 0.05), more frequently lied to others about their penis size (p < 0.001) and took more frequently the passive sexual role (p < 0.05). Men with above average penis were more frequently satisfied with their penis size (p < 0.001), took more frequently the active sexual role (p < 0.01), they had more sexual partners (p < 0.05), more problems with a tight condom (p < 0.001) and more gonorrhoea/Chlamydia infections (p < 0.001) than men with an average penis. Perception of one's penis size was associated with some aspects of sexual behaviour and the frequency of sexually transmitted diseases.
Serbian Journal of Dermatology and Venereology, Sep 1, 2013
The administration of highly active antiretroviral therapy (HAART) has been highly beneficial to ... more The administration of highly active antiretroviral therapy (HAART) has been highly beneficial to patients with HIV-associated skin diseases, but on the other side, in many instances the skin has been affected by side effects of these drugs and manifestations of the immune reconstitution inflammatory syndrome/immune reconstitution disease (IRIS/IRD). Thus, HAART has altered clinical presentations of many skin diseases (6). Moreover, since the introduction of HAART, sexually transmitted infections have been increasing among HIV-infected homosexual men (7, 8). According to the available data and routine surveillance, HIV infection in the Republic of Serbia has been well controlled. In the period of 2010-2011, there were 275 newly diagnosed HIV cases, 103 AIDS cases and 57 AIDS-related deaths reported to the Institute of Public Health of Serbia (Figures 1, 2, 3) (9).
Zdravstvena zaštita, 2020
SAŽETAК Uvod/Cilj: Početkom novog milenijuma došlo je do značajnog porasta obolevanja od sifilisa... more SAŽETAК Uvod/Cilj: Početkom novog milenijuma došlo je do značajnog porasta obolevanja od sifilisa u populaciji Srbije. Cilj ovog rada je bio da se utvrdi učestalost obolevanja od sifilisa u populaciji Beograda u periodu od 2009. do 2018. godine, kao i udeo ranog i kasnog sifilisa u ukupnom broju obolelih. Metode: U radu su korišćeni podaci o novoregistrovanim slučajevima obolevanja od sifilisa, dijagnostikovanog u bilo kom stadijumu bolesti, uzetih iz obaveznih prijava za zarazne bolesti koje stižu sa čitave teritorije Beograda u Gradski zavod za zaštitu zdravlja. Rezultati: U periodu od 2009. do 2018. godine sifilis je dijagnostikovan po prvi put kod 631 osobe, 46 žena (7,3%) i 585 muškaraca (92,7%)-odnos muškarci/žene bio je 12,7 :1. Uz godišnje oscilacije, broj dijagnostikovanih bolesnika je kod muškaraca rastao i najveća nestandardizovana stopa je zabeležena u 2018. godini (17,7 na 100.000). Stopa dijagnostikovanog sifilisa kod žena je varirala po godinama od 0,2 na 100.000, u 2018. godini, do 0,9 na 100.000, u 2012. godini. Uz to, kod žena je značajno češće nego kod muškaraca sifilis po prvi put dijagnostikovan u kasnoj fazi (45,7% prema 12,8%; р < 0,001). Zaključak: Podaci o učestalosti dijagnostikovanog sifilisa u populaciji Beograda su u skladu sa podacima iz drugih evropskih zemalja. Medjutim, činjenica da je sifilis kod nekih obolelih otkriven u kasnom stadijumu ukazuje na to da stope dijagnostikovanog sifilisa, posebno kod žena, u našoj sredini ne predstavljaju pravi pokazatelj epidemiološke situacije.
Epidemiology and Infection, Nov 17, 2005
This paper describes the features of an outbreak of early syphilis in an institution for the care... more This paper describes the features of an outbreak of early syphilis in an institution for the care of adults with mental disorders. A case-note review was performed. In the period June to November 2001, 87 cases of syphilis were diagnosed [25 primary, 21 secondary and 41 early latent syphilis in 983 inmates (crude attack rate 8. 9%)]. Among them 82 were heterosexual, four were homosexual or bisexual, and for one case sexual preference was not established. About half the cases were known to be promiscuous. The initial case was not identified. Penicillin therapy was administered to all cases and all known or suspected sexual contacts. Sporadic cases of syphilis have, however, continued to emerge from time to time. Institutions for patients with mental disorders are vulnerable to sexually transmitted diseases, and special strategies should be devised for their control.
Serbian Journal of Dermatology and Venereology, Mar 1, 2015
Majocchi's granuloma was fi rst described by Domenico Majocchi in 1883, as a deep chronic dermato... more Majocchi's granuloma was fi rst described by Domenico Majocchi in 1883, as a deep chronic dermatophyte infection of hair follicles, in which dermatophytes penetrate the dermis through hair canals, forming granulomatous changes in the dermis and/or hypodermis. Majocchi's granuloma has two different clinical variants: the fi rst is a small perifollicular papular type, seen in otherwise healthy individuals, that occurs secondary to trauma (e.g. in women with chronic tinea pedis that extends to the legs and who shave their legs); the second is a type with deep plaques or nodular lesions in immunocompromised hosts. The diagnosis is primarily made using direct microscopy of unstained specimens and fungal cultures, while additional diagnostics (histology, PCR) are generally not necessary. It is most commonly caused by Trichophyton rubrum. We present a 26-year-old otherwise healthy man exhibiting blue erythematous patches over the skin of his abdomen on clinical examination, which agglomerated to form slightly raised plaques with irregular ovoid contours, spreading from umbilicus to the pubic region; they were covered with multiple red-blue, erythematous partly coalescing scales, eroded, fi rm papules and nodules. On pressure, some nodules excreted viscid and turbid sero-purulent content. The lesions were slightly itchy. The patient was previously unsuccessfully treated during at least 4 weeks with a topical steroid cream prescribed by his physician. Direct microscopy for fungi of skin scrapings and pus mounted in potassium hydroxide was negative. Cultures of the contents and scrapings were performed on Sabouraud's glucose agar and Trichophyton rubrum was isolated. The diagnosis of Majocchi's granuloma was made, and the patient was treated with itraconazole (200 mg daily) for eight weeks, when all lesions resolved and fungal culture was negative. Misapplication of topical corticosteroids over a long period, as in our case, can produce Majocchi's granuloma. When assessing skin lesions of unusual appearance, especially if aggravated by corticosteroids, dermatologists and general practitioners should consider tinea incognito, which may appear in its invasive form of Majocchi's granuloma. The available world literature shows that Majocchi's granuloma presenting as tinea incognito caused by topical corticosteroids has been reported extremely rarely.
Serbian Journal of Dermatology and Venereology, Dec 1, 2013
Case reports Case 1 A 28-year-old man presented with folliculitis unrelated to artificial penile ... more Case reports Case 1 A 28-year-old man presented with folliculitis unrelated to artificial penile nodules. Physical examination accidentally revealed 5 asymptomatic penile nodules, four of them on dorsal part of the penis and one at the prepuce edge (Figure 1). Careful personal history gave insight into the etiology of nodules. These were capsule shaped artificial self-implanted plastic pearls, inserted two years ago by piercing the penile skin with a sharp iron rod, without a local anesthetic. The beads were made from a toothbrush by using sandpaper. The patient was in prison at that time, and suffered no serious side effects after insertion. The aim was to enhance the patient's sexual pleasure and the pleasure of his sexual partners.
PubMed, Apr 26, 2001
Introduction: Sexually transmitted diseases (STDs) comprise a large group of infections caused by... more Introduction: Sexually transmitted diseases (STDs) comprise a large group of infections caused by different microorganisms including spirochetes, bacteria, chlamydia, mycoplasma, protozoa, fungi, parasites, and viruses. A considerable number of patients with sexually transmitted diseases are STD recurrences. As reported by Marijanović and Lalosević, in Belgrade, among patients who visited the City Department of Skin and Venereal Diseases, during 1985 and 1986 because of syphilis or gonorrhea, 22.8% had these diseases two or more times during their lives (male/female ratio 10:1). The aim of this study was to test the hypothesis that there is a relationship between alcohol use and recurrence of STD. Material and methods: A case-control study was performed in Belgrade population, from June, 1997 to April, 1998. Participants were recruited among patients attending the City Department of Skin and venereal Diseases of Belgrade because of sexually transmitted diseases (syphilis, gonorrhea, nongonoccocal urethritis and genital warts). The case group comprised 101 patients who already had STD two or more times in their personal histories. The control group consisted of 210 patients treated at the same institution for micotic diseases, patients who either never had STD or had it only once (13% of controls) in their personal histories. All participants were men aged 20 to 50 years and all were from Belgrade. Data on demographic characteristics, sexual history and sexual behavior, and data on antisocial behavior were collected from all participants using an anonymous questionnaire. In the present paper only data on alcohol use are presented. In the analysis of data chi 2-test was used. Results: STD recurrence patients in comparison to their controls used alcohol more frequently (56.3%:16.1%), especially hard liquors, and 55.5% of them used alcohol at the time of STD infection. Discussion: In the present study STD recurrence patients consumed alcohol more frequently than their controls, especially hard liquors. In the study of Myliueva et al, 50% of venereal disease patients consumed alcohol now and then and 10% consumed alcohol frequently. Scheidt and Windle found that 60% of alcoholics had at least one sexually transmitted disease as the result of a high number of sexual partners, low use of condoms and practicing sex for drugs or money. Alcohol has a depressive effect on central nervous system, reduces anxiety and increases libido. Conclusion: The obtained results support the hypothesis that alcohol use is related to recurrence of STDs.
Zdravstvena zaštita, 2019
_______ 15 SAŽETAK Uvod/Cilj: Iako su sifilis i gonoreja prepoznate kao "stare" polne bolesti dan... more _______ 15 SAŽETAK Uvod/Cilj: Iako su sifilis i gonoreja prepoznate kao "stare" polne bolesti danas predstavljaju "nov" problem. Širom sveta opisan je porast obolevanja od sifilisa koji je često praćen HIV infekcijom, a usled pojave rezistencije gonokoka na sve veći broj antibiotika, gonoreja preti da postane neizlečiva bolest. Cilj ovog istraživanja je bio da se utvrde razlike između obolelih od sifilisa i gonoreje u odnosu na njihove demografske karakteristike i ponašanje. Metode: U studiju preseka uključeni su oboleli od sifilisa i gonoreje koji su se tokom 2016. godine lečili u Gradskom zavodu za kožne i venerične bolesti u Beogradu. Rezultati: U studiju je uključeno 278 pacijenta, 140 (50,4%) sa gonorejom i 138 (49,6%) sa sifilisom. U poređenju sa obolelim od gonoreje, pacijenti sa sifilisom su bili stariji, češće muškog pola i višeg obrazovnog statusa, kasnije su stupali u seksualne odnose-posle 20. godine, ređe su imali stalnog partnera, bili su homoseksualne ili biseksualne orijentacije, a tokom poslednjih šest meseci ćešće su praktikovali oralni i analni seks, kao i seks sa osobama iz inostranstva. Oboleli od sifilisa su ređe davali podatak o gonoreji u ličnoj anamnezi, ali su češće bolovali od sifilisa, hepatitisa B i bili su HIV pozitivni. Zaključak: U poređenju sa obolelima od gonoreje pacijenti sa sifilisom su imali promiskuitetnije ponašanje, HIV pozitivan status i pripadali su populaciji muškaraca koji imaju seks sa muškarcima. Ključne reči: sifilis, gonoreja, muškarci koji imaju seks sa muškarcima, HIV SUMMARY Intoduction/Aim: Although syphilis and gonorrhoea are "old" sexually transmitted diseases they have become a "new" problem: syphilis resurgence is noticed worldwide and it is followed by HIV co-infection, while drugresistant gonorrhoea could be potentially untreatable infection. The aim of this study was to identify any differences between syphilis and gonorrhoea cases in regard to their demographic characteristics and behaviour. Methods: In this cross-sectional study, data were collected from consecutive syphilis and gonorrhoea cases registered at the City Institute for Skin and Venereal Diseases in Belgrade in 2016. Results: The study included 278 cases, 140 (50.4%) with gonorrhoea and 138 (49.6%) with syphilis. In comparison with gonorrhoea patients, syphilis patients were older, more frequently males with higher education, had their first sexual intercourse later, at 20+ years of age, less frequently had a permanent sexual partner, were more frequently homosexual or bisexual, and during the last 6 months had more frequently anal sex and oral-anal sex, as well as sex with a foreigner. They also had gonorrhoea in their personal history less frequently, but more frequently syphilis and hepatitis B infection, and they were more frequently HIV positive. Conclusion: In comparison with gonorrhoea cases, patients with syphilis were more frequently men who have sex with men with more pronounced risk behaviour and HIV co-infection.
Zdravstvena zaštita, 2019
_______ 5 SAŽETAK Uvod/Cilj: Indeks bola i oganičene pokretljivosti ramena (SPADI) se preporučuje... more _______ 5 SAŽETAK Uvod/Cilj: Indeks bola i oganičene pokretljivosti ramena (SPADI) se preporučuje i često koristi za merenje trenutnog bola i nesposobnosti u ambulantnom okruženju. Međutim, validnost i pouzdanost srpskog SPADI upitnika nisu do sada proučavani. Cilj ove studije je bio da se proceni pouzdanost i validnost SPADI upitnika na srpskom jeziku. Metode: Istraživanje je sprovedeno kao panel studija na Institutu za ortopedsko hirurške bolesti "Banjica" (IOHB) u Beogradu. Obuhvaćeno je 33 pacijenata sa sindromom bolnog ramena, koji su bili upućeni na pregled kod lekara na IOHB tokom 2016. i 2017. godine. Srpska verzija SPADI upitnika prevedena je u skladu sa međunarodnim smernicama. Unutrašnja validnost je procenjena određivanjem Cronbach-ovog alfa koeficijenta. Interklasni koeficijent korelacije (ICC) je primenjen za procenu test-retest pouzdanosti. Faktorska analiza je korišćena za ispitivanje konačne strukture upitnika. Rezultati: SPADI upitnik ima odličan nivo unutrašnje konzistentnosti (Cronbach alfa =0,946). Pouzdanost posle ponovonog testiranja SPADI upitnika bila je veoma visoka (ICC =0, 997). Pomoću eksploratorne faktorske analize izdvojen je jedan faktor koji objašnjava 50,1% varijanse. Zaključak: Srpska verzija SPADI upitnika ima visok nivo unutrašnje konzistentnosti i pouzdanosti. Međutim, naši rezultati ukazuju da, iako konceptualno upitnik ima dva domena, naši ispitanici ne prave razliku između bola i ograničenosti pokreta, te se preporučuje samo upotreba ukupnog skora SPADI upitnika.
Serbian Journal of Dermatology and Venereology, Jun 27, 2017
"Contact tracing" or "partner notification" refers to clinicians' efforts to identify sex partner... more "Contact tracing" or "partner notification" refers to clinicians' efforts to identify sex partners of infected persons to ensure their medical evaluation and treatment. For many years partner notification has been a cornerstone in the management of patients diagnosed with sexually transmitted infections (STIs) and it is the essential component in the control of these infections. Clinicians' efforts to ensure the treatment of a patient's sex partners can reduce the risk for re-infection and potentially diminish transmission of STIs. Partner notification includes three different approaches for notifying the sexual partners of the person infected with a STI: provider referral, patient referral, and contract referral. The aim of our study was to evaluate the efficacy of partner notification among syphilis and gonorrhea cases registered at the City Institute for Skin and Venereal Diseases in Belgrade in 2016, and its contribution to prevention and control of these diseases. A retrospective chart review of patients with gonorrhea and early syphilis registered in 2016 was undertaken. We analyzed data about the possible source of infection as well as sexual orientation, provided on the official form for notification of syphilis and gonorrhea. The study included 112 male patients, 67 with gonorrhea and 45 with syphilis. Out of three modalities of partner notification offered to patients, only patient notification of sexual partner/s was accepted. Although all patients accepted this type of partner notification, index patients with gonorrhea notified only 17 partners (25.4%) and index patients with syphilis also notified 17 partners (37.8%). The effectiveness of partner notification for gonorrhea and syphilis cases was only 30.4%, and its contribution to prevention and control of these diseases was lower than we expected. National guidelines offering standardized protocols for partner notification service provision can improve this process, as a novel approach with non-traditional method of partner notification such as patient-delivered partner therapy.
PubMed, Apr 1, 2018
Dear Editor, Proper and consistent use of male condoms can be a highly effective method of preven... more Dear Editor, Proper and consistent use of male condoms can be a highly effective method of preventing the transmission of sexually transmitted infections (STIs) and HIV (1), but this method relies on men's willingness and ability to use condoms. In the United States of America, about 20% overall and less than 50% of adults with multiple partners used a condom at last intercourse (2). In Serbia in 2013 (3), 50.0% of women and 62.5% of men aged 15-49 who had more than one partner in the past year used a condom during their last intercourse. Heterosexual men often use condoms to prevent pregnancy rather than the transmission of venereal diseases (4). For better public promotion of condom use, it is necessary to know the reasons for its inconsistent or incorrect use. With this in mind, we asked 200 consecutive chlamydia-positive heterosexual men admitted to the City Institute for Skin and Venereal Diseases in Belgrade to complete an anonymous questionnaire, taken from a Danish study (5), about their attitudes to/or experience with condoms. Patients were divided into two groups; Group I consisted of 109 (54.5%) men who reported that they had never or sometimes used condoms during intercourse and Group II consisted of 91 (45.5%) men who had used a condom often or always. The majority of participants (68.5%) were ≤30 years old, while the rest were older. The analysis of differences between these two groups was performed using a chi-square test. Attitudes concerning use of condoms are presented in Table 1. The majority of our participants (43.5%) did not use a condom because they had sexual intercourse with regular partners. This may be explained by trust and misperception of risk of contracting STIs during sex with a regular partner or lack of discussion with the partner about condom use. The results of another study about condom use with a steady partner (6) have shown that 31% of participants reported using condoms consistently with steady partners. The second most frequent reason for not using a condom in our participants was the statement that condom decreased sexual pleasure. Several studies (7,8) have reported that this is one of the main reasons for not using a condom. In Randolph et al. (9), both women and men rated unprotected vaginal intercourse as more pleasurable than protected vaginal sex. In particular, men believe that condoms reduce sexual pleasure and they are less likely to use them in practice. Condom-associated erection problems or problems with condom fit were reported by 42% of our participants (items 1, 14, 15 in Table 1). Several studies have shown that men experiencing condom-associated erection problems practiced unprotected vaginal intercourse significantly more frequently than men who did not experience this problem (10,11). Although alcohol use has been found to be an independent and important risk factor for unprotected sex (5,12), only 5.5% of our participants reported that alcohol intake was the main reason for not using a condom. In the present study, participants who had never or sometimes used condoms reported significantly more frequently that they forgot to bring or even use a condom when it was available, which illustrates their risky behavior and unwillingness to use a condom. Patients who had often used a condom reported condom failure significantly more frequently because of their partners refusing to use it. Since men believe more frequently than women that condoms reduce sexual pleasure, the question is whether they could not persuade their partners or find a good excuse not to use it. In summary, the results of the present study indicate the main factors that should be considered when promoting condom use. Such promotion should include advice about using condoms, a demonstration of correct use, and provision of condoms to the patient.
Serbian Journal of Dermatology and Venereology, Dec 20, 2017
Lues maligna is a rare ulcerative form of secondary syphilis. This clinical entity is predominant... more Lues maligna is a rare ulcerative form of secondary syphilis. This clinical entity is predominantly found in patients living with HIV or AIDS. We report a case of a 32-year-old homosexual man with diffuse non-pruritic, papular skin lesions, ulcerated nodules and plaques disseminated on the face, trunk and extremities. The rash was followed by fever, malaise and joint pains. Serological tests for syphilis were positive. The patient was treated with intramuscular penicillin and the lesions resolved completely. Lues maligna was an initial presentation of underlying HIV infection. The HIV seropositivity was confirmed by Western blot analysis. Due to the increased number of syphilis cases and frequent HIV co-infection in Serbia, dermatologists must be able to recognize this condition based on clinical characteristics and risk factors and to diagnose and treat it promptly.
Zdravstvena zaštita, 2021
Early syphilis has been increasing in the Republic of Serbia since 2010 and its infectivity for s... more Early syphilis has been increasing in the Republic of Serbia since 2010 and its infectivity for sexual partners lasts for a year from the moment of infection. The exception is pregnant women who, if left untreated, can transmit the infection to the fetus within four years of infection. Syphilis in pregnancy can cause miscarriage, stillbirth, low birth weight or congenital syphilis. The aim of this paper is to present the clinical manifestations, laboratory diagnostics and therapy of syphilis in pregnancy, as well as to sensitize medical workers to this disease and the introduction of mandatory serological screening tests for syphilis in all pregnant women.
Serbian Journal of Dermatology and Venereology, Sep 1, 2015
European Economic Area, the overall incidence of reported cases was 15.3 per 100.000 people in 20... more European Economic Area, the overall incidence of reported cases was 15.3 per 100.000 people in 2012. Th e highest rates were observed in the United Kingdom (45.4 per 100.000), while low rates (<5 per 100.000) were generally reported in the Central and Eastern Europe. In 2012, there was a low reported incidence of gonorrhea in Serbia (1.49/100.000), as well. Th e purpose of this study was to report on the epidemiology of gonorrhea in Belgrade (about 1.5 million inhabitants) during the period 2010-2014, and to discuss the data in the light of changes in gonorrhea incidence in the European Union.
Zdravstvena zaštita, 2022
Uvod/Cilj: U Beogradu sifilis i infekcija izazvana virusom humane imunodeficijencije (HIV) se naj... more Uvod/Cilj: U Beogradu sifilis i infekcija izazvana virusom humane imunodeficijencije (HIV) se najčešće javljaju među muškarcima koji imaju seksualne odnose sa muškarcima, koji su neretko stigmatizovani i diskriminisani, te se ne usuđuju da rade testiranja na ove bolesti u zdravstvenim ustanovama. Cilj ovog istraživanja je bio da se utvrde prevalencija sifilisa i HIV infekcije među muškarcima koji imaju seksualne odnose sa muškarcima koji su testirani u "check-point" centru udruženja "Potent" u Beogradu. Metode: U ovu studiju preseka uključene su 993 osobe testirane na HIV i 860 osoba testiranih na sifilis brzim skrining testovima HEXAGON SYPHILIS i HEXAGON HIV. Rezultati brzih testova na HIV su potvrđeni pozitivnim Western-Blot testom na Infektivnoj klinici Kliničkog centra Srbije, a na sifilis pozitivnim serološkim testovima (VDRL-Venereal Disease Research Laboratory; laboratorijski test za istraživanje veneričnih bolesti i TPHA-Treponema Pallidum Haemagglutination Assay; Treponema Pallidum hemaglutacioni test) u Gradskom zavodu za kožne i venerične bolesti u Beogradu. U statističkoj analizi podataka korišćene su proporcije, procenti i χ 2 test. Rezultati: Pozitivan test na HIV je zabeležen kod 11 (1,1%), a pozitivan test na sifilis kod 34 ispitanika (3,9%). Najmlađi novootkriveni HIV pozitivni ispitanik imao je 22 godine, a najstariji 46 godina, dok je najmlađa osoba sa pozitivnim testom na sifilis imala 19 godina, a najstarija 68. Zaključak: Strategije testiranja na sifilis i HIV među muškarcima koji imaju seksualne odnose sa muškarcima bi trebalo da budu raznolike uključujući i testiranje u zajednici koje sprovode nevladine organizacije u saradnji sa zdravstvenim ustanovama.
Indian Journal of Dermatology, Venereology and Leprology, Jun 9, 2022
Central European Journal of Public Health, Dec 30, 2017
Objective: A worldwide syphilis incidence increase was recorded at the beginning of the new mille... more Objective: A worldwide syphilis incidence increase was recorded at the beginning of the new millennium, occurring primarily among men who have sex with men (MSM). The aim of this study was to analyse the epidemiological situation of syphilis in the Belgrade population between 2005 and 2014 and to examine the characteristics of an early syphilis outbreak among MSM in Belgrade in 2014. Method: Reporting of syphilis is compulsory in Serbia. Routinely reported data were analysed along with data collected from patients' charts. Results: During the period observed, syphilis incidence increased from 1.07 per 100,000 in 2005 to 4.1 per 100,000 in 2014 (383.2%). From 2005 to 2009, syphilis rates in Belgrade were low, around 1 case per 100,000 people. The first outbreak was registered in 2010. The new incidence increase happened in 2012, and again in 2014 when it was the highest. These incidence changes were registered mainly in men, where the frequency of syphilis was much higher than in women. In 2014, primary syphilis was diagnosed in 20 cases, secondary syphilis in 42, and early latent syphilis in 9 patients. Fifty-seven were MSM, 10 were heterosexual men and 4 were women. Twenty-four cases, all MSM were co-infected with HIV. Majority of patients acquired infection in Belgrade, while in 42/71 cases oral sex was the only risk factor. In comparison with HIV negative, HIV positive syphilis patients were older, more frequently unemployed and MSM. They also more frequently had sex with unknown partners and were diagnosed in the secondary stage of infection. Conclusions: Study results underline the need for coordinated and expeditious surveillance, partner services, enhanced screening of population at risk, health education, as well as early diagnosis and treatment.
Anais Brasileiros De Dermatologia, Nov 1, 2019
Timočki medicinski glasnik, 2020
Introduction: Several studies have shown increasing rates of many sexually transmitted diseases (... more Introduction: Several studies have shown increasing rates of many sexually transmitted diseases (STDs) in the population group aged 50 years and older, worldwide. Older persons usually know less about STDs and HIV/AIDS than younger individuals. The aim of the present study was to reveal why older patients seek venereologists' help and to assess their knowledge of STDs. Material and Methods: Data were collected from consecutive patients aged 60 and over who attended counselling for sexually transmitted diseases at the City Institute for Skin and Venereal Diseases in Belgrade from July to December 2017. One dermatologist examined and interviewed all participants by the use of a questionnaire. Results: Out of all participants (174 patients), 23.56% had some of STIs, 58.62% had some other genital disorders and 17.82 came for counselling. The most frequent viral STDs were acute and recurrent genital warts and recurrent genital herpes, while the most frequent bacterial STD was syphilis. Out of non STDs the most frequent were balanitis, in men, and lichen sclerosis in both sexes. The perceived knowledge mean scores for each STD, ranging from "0", meaning not knowledgeable at all, to "5", meaning very knowledgeable, ranged from 0.63 to 2.71. It was the best for syphilis, followed by gonorrhoea, HIV/AIDS, hepatitis B, genital warts and Chlamydia. Correct answers concerning general knowledge of STDs were given by 59% to 96% of participants. Conclusion: A considerable number of older people who sought venereologists' help had an STD. Their general knowledge of STDs as well as perceived knowledge of single STDs were unsatisfactory and did not differ between patients with and without STDs.
Acta Facultatis Medicae Naissensis, Dec 1, 2018
Penis size is a major body image concern for the majority of men in western nations, while in gay... more Penis size is a major body image concern for the majority of men in western nations, while in gay culture the penis has become a body part linked to sexual attractiveness and viability. The aim of this study was to reveal influence of the perceived penis size on sexual behaviour, condom use, sexually transmitted infections and men's sexual positioning among men who have sex with men. In this cross-sectional study, the data were collected from consecutive men who have sex with men who attended Counselling for Sexually Transmitted Diseases at the City Institute for Skin and Venereal Diseases in Belgrade, Serbia. Out of 319 participants, 6.6% perceived their penis as "below average", 71.5% as "average", and 21.9% as "above average". In comparison with men with an average penis, men with below average penis were more frequently unsatisfied with their penis size (p < 0.05), more frequently lied to others about their penis size (p < 0.001) and took more frequently the passive sexual role (p < 0.05). Men with above average penis were more frequently satisfied with their penis size (p < 0.001), took more frequently the active sexual role (p < 0.01), they had more sexual partners (p < 0.05), more problems with a tight condom (p < 0.001) and more gonorrhoea/Chlamydia infections (p < 0.001) than men with an average penis. Perception of one's penis size was associated with some aspects of sexual behaviour and the frequency of sexually transmitted diseases.
Serbian Journal of Dermatology and Venereology, Sep 1, 2013
The administration of highly active antiretroviral therapy (HAART) has been highly beneficial to ... more The administration of highly active antiretroviral therapy (HAART) has been highly beneficial to patients with HIV-associated skin diseases, but on the other side, in many instances the skin has been affected by side effects of these drugs and manifestations of the immune reconstitution inflammatory syndrome/immune reconstitution disease (IRIS/IRD). Thus, HAART has altered clinical presentations of many skin diseases (6). Moreover, since the introduction of HAART, sexually transmitted infections have been increasing among HIV-infected homosexual men (7, 8). According to the available data and routine surveillance, HIV infection in the Republic of Serbia has been well controlled. In the period of 2010-2011, there were 275 newly diagnosed HIV cases, 103 AIDS cases and 57 AIDS-related deaths reported to the Institute of Public Health of Serbia (Figures 1, 2, 3) (9).
Zdravstvena zaštita, 2020
SAŽETAК Uvod/Cilj: Početkom novog milenijuma došlo je do značajnog porasta obolevanja od sifilisa... more SAŽETAК Uvod/Cilj: Početkom novog milenijuma došlo je do značajnog porasta obolevanja od sifilisa u populaciji Srbije. Cilj ovog rada je bio da se utvrdi učestalost obolevanja od sifilisa u populaciji Beograda u periodu od 2009. do 2018. godine, kao i udeo ranog i kasnog sifilisa u ukupnom broju obolelih. Metode: U radu su korišćeni podaci o novoregistrovanim slučajevima obolevanja od sifilisa, dijagnostikovanog u bilo kom stadijumu bolesti, uzetih iz obaveznih prijava za zarazne bolesti koje stižu sa čitave teritorije Beograda u Gradski zavod za zaštitu zdravlja. Rezultati: U periodu od 2009. do 2018. godine sifilis je dijagnostikovan po prvi put kod 631 osobe, 46 žena (7,3%) i 585 muškaraca (92,7%)-odnos muškarci/žene bio je 12,7 :1. Uz godišnje oscilacije, broj dijagnostikovanih bolesnika je kod muškaraca rastao i najveća nestandardizovana stopa je zabeležena u 2018. godini (17,7 na 100.000). Stopa dijagnostikovanog sifilisa kod žena je varirala po godinama od 0,2 na 100.000, u 2018. godini, do 0,9 na 100.000, u 2012. godini. Uz to, kod žena je značajno češće nego kod muškaraca sifilis po prvi put dijagnostikovan u kasnoj fazi (45,7% prema 12,8%; р < 0,001). Zaključak: Podaci o učestalosti dijagnostikovanog sifilisa u populaciji Beograda su u skladu sa podacima iz drugih evropskih zemalja. Medjutim, činjenica da je sifilis kod nekih obolelih otkriven u kasnom stadijumu ukazuje na to da stope dijagnostikovanog sifilisa, posebno kod žena, u našoj sredini ne predstavljaju pravi pokazatelj epidemiološke situacije.
Epidemiology and Infection, Nov 17, 2005
This paper describes the features of an outbreak of early syphilis in an institution for the care... more This paper describes the features of an outbreak of early syphilis in an institution for the care of adults with mental disorders. A case-note review was performed. In the period June to November 2001, 87 cases of syphilis were diagnosed [25 primary, 21 secondary and 41 early latent syphilis in 983 inmates (crude attack rate 8. 9%)]. Among them 82 were heterosexual, four were homosexual or bisexual, and for one case sexual preference was not established. About half the cases were known to be promiscuous. The initial case was not identified. Penicillin therapy was administered to all cases and all known or suspected sexual contacts. Sporadic cases of syphilis have, however, continued to emerge from time to time. Institutions for patients with mental disorders are vulnerable to sexually transmitted diseases, and special strategies should be devised for their control.