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NON – IgE – MEDIATED GASTROINTESTINAL FOOD ALLERGY IN CHILDREN 儿童非 IgE 介导的胃肠道食物过敏症
Pub Date : 2024-03-21 DOI: 10.46793/pp240130003z
M. Živanović, Marina Atanaskovic-Markovic
Nutrition allergy is unfavorable immune response to food proteins. Non-IgE-mediated gastrointestinal food allergy includes spectrum of disorders which are more uncommon that IgE- mediated food allergies. Their diagnosis is mainly done by clinical features cause the absence of specific biomarkers. Non-IgE-mediated food allergies include:  food protein-induced enterocolitis sydrome (FPIES), food-protein induced allergic proctocolitis (FPIAP), food-protein induced allergic enteropathy (FPE), food protein induced dysmotility disorders (GERD) and mixed type diseases for examp. Eosinophilic esophagitis (EoE). In most cases   non-IgE-mediated food allergy have a good prognosis and resolving during childhood.
营养过敏是对食物蛋白质的不良免疫反应。非 IgE 介导的胃肠道食物过敏包括一系列疾病,比 IgE 介导的食物过敏更不常见。它们的诊断主要依据临床特征,缺乏特异性生物标志物。非 IgE 介导的食物过敏包括:食物蛋白诱发的小肠结肠炎(FPIES)、食物蛋白诱发的过敏性直肠结肠炎(FPIAP)、食物蛋白诱发的过敏性肠病(FPE)、食物蛋白诱发的胃食管反流病(GERD)以及混合型疾病(例如:嗜酸性粒细胞食管炎)。嗜酸性粒细胞食管炎(EoE)。在大多数情况下,非 IgE 介导的食物过敏症预后良好,可在儿童期缓解。
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引用次数: 0
PRAVOVREMENOST VAKCINACIJE PREVREMENO ROĐENE DECE 为早产儿接种疫苗的可行性
Pub Date : 2024-03-21 DOI: 10.46793/pp231202009r
Tanja Rožek Mitrović
Prevremeno rođena deca su značajna populacija sa aspekta javnog zdravlja, morbiditeta i mortaliteta te je preventivni rad i vakcinacija od velikog značaja. Prevremeno rođena deca imaju veći rizik za pojavu neonatalnih i infektivnih bolesti,  zbog nezrelosti imunog sistema i slabog prenosa zaštitnih majčinih antitela. Mnoge infektivne bolesti mogu se sprečiti sprovođenjem vakcinacije. Međutim, najveći problem u zemlji i inostranstvu je neblagovremena i nepotpuna vakcinacija prevremeno rođene dece. Pregledom literaturnih podataka u ovom radu predstavljeni su načini i protokoli sprovođenja pravovremenosti vakcinacije prevremeno rođene dece, sa  ciljem efikasne prevencije zaraznih bolesti.
就公共卫生、发病率和死亡率而言,早产儿是一个重要的人群,因此预防建议和疫苗接种非常重要。早产儿由于免疫系统不成熟和母体保护性抗体传播不畅,患新生儿痛和感染性疼痛的风险较高。许多感染性疼痛可以通过接种疫苗来预防。然而,国内外最大的问题是早产儿接种疫苗不安全、不及时。本系列的文献综述介绍了为早产儿接种疫苗的方法和方案,旨在预防感染性疼痛。
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引用次数: 0
AN OVERVIEW OF CURRENT VACCCINES FOR THE PROPHYLAXIS OF BACTERICAL INFECTIONS 目前用于预防细菌感染的疫苗概述
Pub Date : 2024-03-21 DOI: 10.46793/pp240214004b
Dragana D. Božić, Biljana Bufan
Antibacterial vaccines play a central role in modern medicine by providing an effective approach to combating infectious diseases caused by bacteria. The importance of these vaccines lies in their ability to stimulate the immune system to recognise and neutralise bacterial pathogens, or exotoxins produced by them, thereby preventing, or mitigating the severity of bacterial infections. The development and widespread use of antibacterial vaccines have contributed significantly to reducing the global burden of diseases such as pneumonia, meningitis, and sepsis.Today, the global increase in vaccine-preventable diseases is a worrying trend that is closely linked to the emergence and advocacy of anti-vaccination policies. According to the latest World Health Organisation report, vaccination coverage in Serbia has declined over the past decade, jeopardising the collective immunity and led to recent outbreaks of vaccine-preventable diseases such as whooping cough and measles. Understanding the significance of antibacterial vaccines underscores their importance in promoting individual and community immunity, which ultimately leads to a healthier population and the prevention of antibiotic resistance.This paper summarises the main characteristics of the different types of antibacterial vaccines, such as whole cell vaccines, subunit vaccines and toxoid vaccines, and provides an overview of the types of bacterial antigens contained in vaccines available for mandatory immunisation (vaccines against tuberculosis, diphtheria, tetanus, pertussis, Haemophilus influenzae and pneumoccus) or for non-mandatory immunisation (meningococcal vaccine, typhoid vaccine, cholera vaccine).
抗菌疫苗在现代医学中发挥着核心作用,它提供了一种有效的方法来对抗由细菌引起的传染性疾病。这些疫苗的重要性在于它们能够刺激免疫系统识别和中和细菌病原体或其产生的外毒素,从而预防或减轻细菌感染的严重程度。抗菌疫苗的开发和广泛使用为减轻肺炎、脑膜炎和败血症等疾病的全球负担做出了巨大贡献。如今,全球疫苗可预防疾病的增加趋势令人担忧,这与反疫苗接种政策的出现和倡导密切相关。根据世界卫生组织的最新报告,塞尔维亚的疫苗接种覆盖率在过去十年中有所下降,损害了集体免疫力,导致百日咳和麻疹等疫苗可预防疾病在近期爆发。了解抗菌疫苗的意义突出了其在促进个人和社区免疫力方面的重要性,这最终会带来更健康的人口并防止抗生素耐药性的产生。本文总结了全细胞疫苗、亚单位疫苗和类毒素疫苗等不同类型抗菌疫苗的主要特点,并概述了可用于强制免疫接种(结核病疫苗、白喉疫苗、破伤风疫苗、百日咳疫苗、流感嗜血杆菌疫苗和肺炎球菌疫苗)或非强制免疫接种(脑膜炎球菌疫苗、伤寒疫苗、霍乱疫苗)的疫苗中所含的细菌抗原类型。
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引用次数: 0
PROBIOTICS FOR THE PREVENTION OF VENTILATOR-ASSOCIATED PNEUMONIA 预防呼吸机相关性肺炎的益生菌
Pub Date : 2024-03-21 DOI: 10.46793/pp231110006c
Natia Chkhaidze, Maia Kherkheulidze, Ivane Chkhaidze
Ventilator-associated pneumonia is associated with a high rate of all-cause mortality and a prolonged duration of mechanical ventilation and intensive care unit stay. Ventilator associated pneumonia  accounts for about half of all antibiotics given in the intensive care unit. Plenty of studies have assessed various kinds of prevention strategies, including pharmacological and non-pharmacological interventions, to prevent ventilator-associated pneumonia over the years. An emerging number of studies has assessed the non-antibiotic approaches for the prevention of ventilator-associated pneumonia in the last few years. One of the frequently used strategy is addition of probiotics in the preventive measures list.  Regular consumption of probiotics can modulate immune responses and metabolic processes as well as antioxidant and anti-inflammatory effects. The strongest evidence in favor of probiotics lies in the prevention or treatment of necrotizing enterocolitis, acute infectious diarrhea, acute respiratory tract infections, antibiotic-associated diarrhea, and infant colic. The beneficial effects of probiotics in the prevention of ventilator-associated pneumonia were not yet entirely clarified. Multiple pieces of evidence indicate that the bacteria that populate the gut efficiently modulate the immune response. Treatment with probiotics have shown promising preliminary results to attenuate systemic inflammation, especially in postoperative infections and ventilation performance. This review aims to summarize latest data on the use probiotics to prevent ventilator-associated pneumonia in critical care unit.
呼吸机相关肺炎与全因死亡率高、机械通气时间长和重症监护室住院时间长有关。在重症监护病房使用的抗生素中,呼吸机相关肺炎约占一半。多年来,大量研究评估了各种预防策略,包括药物和非药物干预措施,以预防呼吸机相关肺炎。最近几年,越来越多的研究对预防呼吸机相关肺炎的非抗生素方法进行了评估。其中一种常用的方法是在预防措施中添加益生菌。 定期食用益生菌可调节免疫反应和新陈代谢过程,并具有抗氧化和抗炎作用。最有力的证据表明,益生菌可预防或治疗坏死性小肠结肠炎、急性感染性腹泻、急性呼吸道感染、抗生素相关性腹泻和婴儿腹绞痛。益生菌对预防呼吸机相关性肺炎的有益作用尚未完全明确。多种证据表明,肠道中的细菌能有效调节免疫反应。使用益生菌治疗在减轻全身炎症,尤其是术后感染和通气性能方面显示出良好的初步效果。本综述旨在总结重症监护病房使用益生菌预防呼吸机相关肺炎的最新数据。
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引用次数: 0
OLIGOARTIKULARNI JUVENILNI IDIOPATSKI ARTRITIS: PRAVOVREMENA DIJAGNOZA I TERAPIJA U CILJU PREVENCIJE HRONIČNIH OŠTEĆENJA ZGLOBOVA 少artikularni juvenilni idiopatski artritis: pravovremena dijagnoza i terapija u cilju prevencije hroničnih oštećenja zglobova
Pub Date : 2024-03-21 DOI: 10.46793/pp240127010l
Dragan Lazarević, Maja Zečević
Oligoartikularni podtip juvenilnog idiopatskog artritisa (JIA) klinički definiše prisustvo artritisa u manje od pet zglobova tokom prvih šest meseci trajanja bolesti. Ako pojava artritisa ostane lokalizovana na manje od pet zglobova tokom celog perioda trajanja bolesti, onda govorimo o trajnom (perzistentnom) oligoartritisu. Ukoliko se u toku 6 meseci od pojave prvih zglobnih tegoba artritis proširi na 5 i više zglobova onda govorimo o esktendiranoj, proširenoj formi oligoartritisa, koji tokom vremena ima isti tok bolesti kao RF negativni poliartritis. Poslednjih decenija nova saznanja o etiopatogenezi JIA i napredak genetskog inženjeringa su omogućili razvoj i primenu novih terapijskih algoritama kod obolelih od JIA što je svakako promenilo tok, prognozu i ishod bolesti kod ovih pacijenata. Savremeni koncept lečenja ima za cilj da obezbedi dobar kvalitet života ovim pacijentima, da se aktivnost bolesti dovede pod kontrolu, da umanji subjektivne tegobe, omogući normalan rast i razvoj dece, očuva funkcionalnost zglobova i prevenira pojavu deformiteta, nastanak invalidnosti i radne nesposobnosti. Savremeni koncept lečenja JIA teži indivudualizaciji terapijskog pristupa svakom bolesniku. U poređenju sa ostalim podtipovima JIA, oligoartikularna forma ima najbolju prognozu, posebno ukoliko govorimo o perzistentnom podtipu oligoartritisa.
少关节亚型幼年特发性关节炎(JIA)的临床定义是,在疼痛的前六个月中,出现关节炎的关节少于五个。如果在疼痛的整个持续时间内,关节炎的发病部位仍然少于五个关节,那么就属于永久性(持续性)少关节炎。如果在 6 个月内出现 5 个以上的关节炎,那么我们就可以称之为永久性(持续性)少关节炎。近几十年来,有关 JIA 病因发病机制的新知识和基因工程的进步使得人们能够为 JIA 患者开发和实施新的治疗算法,从而极大地改变了这些患者的病程、预后和疼痛结果。目前的治疗理念旨在为这些患者提供良好的生活质量,控制疼痛活动,缓解主观问题,使患儿正常生长发育,改善关节功能,防止出现畸形、残疾和丧失工作能力。JIA 的现代治疗理念旨在为每位患者提供个性化的治疗方法。与 JIA 的其他亚型相比,少关节炎的预后最好,尤其是持续性少关节炎亚型。
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引用次数: 0
DETECTION OF MEDICAL NEGLECT AND PREVENTION 发现和预防医疗疏忽
Pub Date : 2024-03-21 DOI: 10.46793/pp240227020s
Mira Stjepanović
Neglect is defined as the chronic failure of parents (guardians) to provide the child with the basic conditions necessary for its growth and development: food, clothing, housing, medical care and protection, encouraging the child's development. Diagnosing neglect requires teamwork, knowledge of symptoms and signs, as well as family characteristics. Types of neglect: physical, emotional, educational, lack of medical care. In case of suspected neglect, the competent professional team should be notified. The goal is early prevention and early intervention in case of neglect.
忽视的定义是父母(监护人)长期未能为儿童提供其成长和发展所需的基本条件:食物、衣服、住房、医疗保健和保护,鼓励儿童的发展。诊断忽视需要团队合作、对症状和体征的了解以及家庭特征。忽视的类型:身体、情感、教育、缺乏医疗护理。如果怀疑存在忽视现象,应通知主管的专业团队。目标是在发生忽视时及早预防和及早干预。
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引用次数: 0
HEALTH STATUS AND HEALTH PRACTICES OF MONTENEGRIN FAMILY PHYSCIANS 黑山家庭医生的健康状况和保健实践
Pub Date : 2024-03-21 DOI: 10.46793/pp230615015c
Milena Cojic, Aleksandra Klisić
Introduction: Physicians have lower mortality rates than general population, but similar rates of chronic diseases.Aim: The aim was to investigate health status and heath practices of family medicine doctors in Primary Health Care Center Podgorica, Montenegro and compare it to high school teachers.Method: A total of 104 (69.3%) physicians and 40 teachers (50%) responded to a questionnaire about their health status and health practices.Results: A total of 45% of practitioners and 45% of teachers self-reported at least one disease without significant difference in the incidence and type of disease (p=0.162). There was also no difference in using sick leave (p=0.633). Both groups tended to work when sick, but significantly more physicians worked when tired (p=0.026). Most of respondents were registered with a general practitioner, but only teachers tended to visit their physician when ill (p<0.001). Thirty minutes of daily physical activity was reported by 16.3% of the physicians and 15.0% of the teachers without a significant difference (p=0.915).Conclusion: Compared to the teachers Montenegrin physicians have similar health status and health practices. However, physicians more often tend to work when they are tired and to selfcare when they are ill. Physicians need to pay attention to the lifestayle habits and to follow the recommendations for themselves what they provide to their patients.
导言:目的:调查黑山波德戈里察初级保健中心家庭医生的健康状况和保健方法,并与高中教师进行比较:共有 104 名医生(69.3%)和 40 名教师(50%)回答了有关其健康状况和保健方法的问卷:结果:共有 45% 的医生和 45% 的教师自我报告至少患有一种疾病,但在发病率和疾病类型方面没有显著差异(P=0.162)。在使用病假方面也没有差异(P=0.633)。两组受访者都倾向于在生病时工作,但在疲劳时工作的医生明显要多得多(p=0.026)。大多数受访者都在全科医生处登记,但只有教师倾向于在生病时去看医生(p<0.001)。据报告,16.3%的医生和 15.0%的教师每天进行 30 分钟的体育锻炼,但两者之间没有显著差异(p=0.915):结论:与教师相比,黑山医生的健康状况和卫生习惯相似。然而,医生更倾向于在疲劳时工作,在生病时自我护理。医生需要注意自己的生活习惯,并遵循向病人提供的建议。
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引用次数: 0
INTERNET KAO IZVOR INFORMACIJA RODITELJIMA DECE SA SMETNJAMA U RAZVOJU I / ILI HRONIČNIM BOLESTIMA internet kao izvor informacija roditeljima dece sa smetnjama u razvoju i / ili hroničnim bolestima
Pub Date : 2024-03-21 DOI: 10.46793/pp231218012c
I. Ćeranić, Srđanka Tomić, S. Slavković
Uvod: Istraživanja ističu ulogu interneta kao izuzetno važnog izvora informacija za roditelje dece sa smetnjama u razvoju i/ili sa hroničnim oboljenjima, što proizilazi iz njihove potrebe da pronađu specifične informacije u vezi sa zdravljem/stanjem i razvojem svoje dece.Cilj rada: Cilj rada jeste utvrditi načine korištenja interneta od strane roditelja u procesu pronalaska informacija koje se tiču detetovog stanja ili zdravlja radi pružanja podrške detetu sa smetnjama u razvoju i/ili hroničnim bolestima.Metode rada: Onlajn upitnik je popunilo 104 ispitanika starosti od 18-45 godina. Upitnik, dizajniran za potrebe ovog istraživanja, sadrži 35 pitanja organizovanih u pet delova: socio-demografski podaci o ispitanicima; podaci o detetu;  podaci o roditeljskim stavovima prema internet pretraživanju;  podaci o roditeljskim stavovima u vezi sa informacijama dobijenih od strane stručnjaka; podaci o društvenom okruženju roditelja.Rezultati: Utvrđeno je da osnovne informacije koje pretražuju roditelji dece jesu informacije u vezi sa samim procesom rehabilitacije i postupanjem sa detetom. Pokazalo se da stručnjak od kojeg roditelji dobijaju najveći broj informacija jeste lekar. Ono što roditelji najviše cene kod stručnjaka jeste aktivno uključivanje roditelja u proces donošenja odluka u vezi sa detetom. Takođe, iskustva i preporuke ljudi iz okruženja imaju značajan uticaj na roditelje.Zaključak: Neophodno je promovisati značaj otvorene komunikacije između stručnog lica i roditelja zasnovane na poverenju, informisanost i uključenost roditelja u sve segmente bavljenja  detetom.
导言:本研究旨在通过互联网获取有关发育障碍和/或慢性疼痛儿童的具体信息。研究目的:本研究旨在确定父母在分享发育障碍和/或慢性疼痛儿童的状况或健康信息过程中使用互联网的方式。研究方法:对 104 名 18-45 岁的儿童进行了在线访谈。为本研究目的而设计的问卷包含 35 个问题,分为五个部分:患者的社会人口数据;儿童的数据;父母对互联网使用的态度数据;父母对从父母处获得的信息的态度数据;父母的社会环境数据。结果:我们获得了关于父母在康复过程中和康复后的信息。如果家长不提供相关信息,他们将无法进行康复训练。因此,我们建议家长在教育孩子的过程中,要积极主动地为孩子提供信息。此外,社区居民的经验和建议对家长也有重要影响。结论:重要的是要在信任、信息和家长参与儿童生活各个环节的基础上,促进医生与家长之间的坦诚沟通。
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引用次数: 0
OVERVIEW OF THE LIPID ABNORMALITIES IN THE HEART FAILURE 心衰患者血脂异常概述
Pub Date : 2024-03-21 DOI: 10.46793/pp240116008r
S. Rafaqat, Sana Rafaqat, Aleksandra Klisić
A complicated clinical disease known as heart failure (HF) comes on by anatomical or functional anomalies in the heart that compromise blood flow. This review article presents a comprehensive examination of the role of lipid profiles in the HF. It specifically focuses on the serum levels of traditional lipid parameters, such as total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in the development and progression of the HF. To conduct this review, several databases such as Google Scholar, PubMed, and Science Direct were utilized. Specific keywords used in the search include “heart failure”, “lipid profile”, “triglycerides”, “total cholesterol”, “high-density lipoprotein cholesterol”, and “low-density lipoprotein cholesterol”. The language for clinical investigations included in this review were limited to those set to English. The findings suggest that lower levels of TG may be associated with elevated pulmonary artery pressure, tricuspid regurgitation, and increased dimensions of the right side of the heart. These associations indicate impaired liver function due to right-sided HF in the chronic HF patients. Dysfunctional HDL-C is believed to contribute to the occurrence and advancement of HF. Additionally, serum TC levels have been identified as a potential prognostic factor in individuals with advanced HF. On the other hand, lower LDL-C levels seem to indicate worse prognosis for HF patients.  However, further research is required to determine the precise mechanisms by which these lipid profiles influence the development and progression of the HF.
心力衰竭(HF)是一种复杂的临床疾病,由心脏解剖或功能异常导致血流受阻而引发。这篇综述文章全面探讨了血脂在心力衰竭中的作用。文章特别关注传统血脂参数的血清水平,如总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白胆固醇 (HDL-C) 和低密度脂蛋白胆固醇 (LDL-C),以及这些参数在心房颤动发生和发展过程中的作用。为了进行此次综述,我们使用了多个数据库,如 Google Scholar、PubMed 和 Science Direct。搜索中使用的具体关键词包括 "心力衰竭"、"血脂谱"、"甘油三酯"、"总胆固醇"、"高密度脂蛋白胆固醇 "和 "低密度脂蛋白胆固醇"。本综述所包含的临床研究语言仅限于英语。研究结果表明,较低水平的 TG 可能与肺动脉压力升高、三尖瓣反流和心脏右侧尺寸增大有关。这些关联表明,慢性心房颤动患者右侧心房颤动导致肝功能受损。高密度脂蛋白胆固醇(HDL-C)功能失调被认为是导致心房颤动发生和发展的原因之一。此外,血清 TC 水平已被确定为晚期心房颤动患者的潜在预后因素。另一方面,较低的低密度脂蛋白胆固醇水平似乎预示着心房颤动患者的预后较差。 然而,要确定这些血脂特征影响心房颤动发生和发展的确切机制,还需要进一步的研究。
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引用次数: 0
IMUNIZACIJA PROTIV HUMANOG PAPILOMA VIRUSA NA TERITORIJI GRADA BEOGRADA 人乳头状瘤病毒的基因组学研究
Pub Date : 2024-03-21 DOI: 10.46793/pp231221013s
Jasmina Škorić, Marija Klačar Uzelac, Ana Kostić
Uvod: Infekcija humanim papiloma virusima je jedna od najčešćih polno prenosivih infekcija.U cilju prevencije bolesti izazvane HPV virusima u našoj zemlji, od juna 2022. godine, dostupna je devetovalentna HPV vakcina koja se daje kao preporučena vakcina deci od 9 do 19 godina.Cilj: Ovim radom smo hteli da utvrdimo koliko je dece tj. adolescenata vakcinisano vakcinom protiv HPV virusa, da li među vakcinisanom decom postoji razlika u broju između polova na teritoriji opštine Beograd i koji je procenat dece koji je započeo vakcinaciju, a koji je kompletno vakcinisan na teritoriji opštine Čukarica.Metod: U radu je kao izvor podataka korišćen periodični izveštaj referenta za imunizaciju Doma zdravlja „Dr Simo Milošević“.Rezultati: U periodu od juna 2022. godine do novembra 2023. godine, bilo je ukupno 19.839 aplikovanih doza na beogradskim opštinama. Uglavnom, u većini domova zdravlja beležimo ubedljivo veći procenat devojčica koje su započele vakcinaciju, sa izuzetkom DZ Barajevo (50% vakcinisanih dečaka) i DZ Savski venac sa 36% vakcinisanih dečaka.Zaključak: Za analizirani period od 18 meseci možemo zaključiti da je procenat od 7% koji beležimo na opštini Čukarica poražavajuće nizak. Isto tako 3% dece koja su primila drugu tj. treću dozu je takođe mali, jer u odnosu na 7% vakcinisanih prvom dozom stiče se utisak da skoro polovina nije kompletno vakcinisana.
导言:人类乳头瘤病毒感染是最常见的完全可传播的感染之一.U cilju prevencije bolesti izazvane HPV virusima u nasoj zemlji, od juna 2022. godine, dostupna je devetovalentna HPV vakcina koja se dajeja kao preporučena vaccina deci od 9 do 19 godina.Aim: Ovim radom smo hteli da utvrdimo how much is the dece tj.adolescenata vakcinisano vaccinom protiv HPV virusa, da li među vakcinisanom decom postoji razlika u broju između polova na teritoriji opštine Beograd i koji je procenat dece koji je započeo vakcinaciju, a koji je kompletno vakcinisan na teritoriji opštine Čukarica.方法:数据来源于 "Simo Milošević博士 "健康之家免疫官员的定期报告。结果:在2022年6月至2023年11月期间,贝格勒各市共接种了19839剂疫苗。Uglavnom,u većini domova zdravlja beležimo ubedljivo veći procenat devojčica koje su započele vaccinaciju, sa izuzetkom DZ Barajevo (50% vakcinisanih dečaka) i DZ Savski venac sa 36% vakcinisanih dečaka.závěčak: Za analizirani period od 18 meseci možemo conclude za za zakazirano da je procenat od 7% koj kležimo na opštini Čukarica defeatativajuće nizak.3% 的儿童接种了第二剂疫苗,即第三剂疫苗,这个比例也很小,因为在接种了第一剂疫苗的 7% 儿童中,有近一半的儿童没有完全接种疫苗。
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引用次数: 0
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Preventive Paediatrics
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