Questions & Answers

It is well known, among the professionals and scientists, but also in the general population, that physical activity is very important for the growth and development of children of school age, as well as for the period of early childhood and adolescence.
The benefits of regular exercise are better body position, stronger bones and muscles, less tandency to the flu, reduced risk of heart disease, diabetes and obesity. In that sense, what is most striking to parents is the adaptation of the body composition. This adaptation is seen mainly as weight loss. Unlike body weight, body height is not under the influence of physical activity, but directly depends on the height of the parents.
In addition to physical health, regular physical activity leads to an improvement in cognitive development and emotional maturation.

Children, who are physically active, require an advanced pediatric examination and regular check-ups. And if the child is involved in the tournaments then additional testing is required.
The general and special health status is assessed through premedical examination, periodic and special health examination.
Premedical examination is necessary to be before they are involved in any sports activities or at the first entry for some sporting activity. Periodic medical examinations are carried out during the whole time while child is engaged in some sport and special according to medical indications.

Assessment of the general health status of children aged 6 to 14 for engaging in sports activities include: anamnesis; weight and height measurement, body mass index, waist measurement; assessment of blood pressure; physical examination of body systems; 12-lead ECG; laboratory examinations: complete blood count (haemoglobin, haematocrit, eritrocytes, leukocytes, plates); risk factors assessment; data entry in medical documentation.
All these assessments can be performed in our institution by top experts in this field, pediatricians, whose opinion is appreciated and in foreign centres.

If physician assesses, on the basis of the general health status of children aged 6 to 14, that it is necessary to carry out additional tests, the child is referred to special examinations.
Additional according to rule of the determining the health competence of athletes for performing sporting activities and participating in sports competitions of the Ministry of Health and the Ministry of Youth and Sports of the Republic of Serbia, we should determining the special medical ability for dealing with a particular sports branch, and directing to the sports branch and sports discipline in which, based on established predispositions, child can expect the greatest success.

Assessment of the special health status of children aged 6 to 14 for engaging in sports activities include, as addition to assessment of the general health status, blood glucose levels; urine test (levels of proteins and sugar); ergometer tests in accordance to the age on ergocicle or tredmill with continuous ECG monitoring; and risk factors assessment.
All these assessments can be performed in our institution by top experts in this field, pediatricians.If it is necessary, we should organize consilium in order to determine ability for sports competition, and this represent the great advantage of our centre.

Regular check-ups will be organised according to the need and within the time interval the doctor assesses.

Health education is every combination of learning through a theory-based experience that enables individuals, groups and the community to acquire the knowledge and skills needed to make decisions about health. It is an active process of learning and training individuals and the community to use acquired knowledge of psychic, physical and social health. At the same time, it indicates the risk factors that can lead to the disease.

– prevention and control of the disease
– the use of psychoactive substances
– nutrition and physical activity
– personal hygiene
– mental health
– injury prevention
– family health
– environment and health
– community health.

Health care can be performed individually or in groups (less than 10 people and more than 30 people).

According to the Sports Act and the Rules about the health status of athletes for performing sporting activities and participation in sports competitions, of the Ministry of Youth and Sport and the Ministry of Health, the Republic of Serbia, it is necessary to determine the special medical ability for dealing with a particular sports branch, ie sports discipline and orientation towards sports branch and sports discipline in which, based on established predispositions, one can expect the greatest success.
According to Article 19 of the Sports Act, athletes or sports experts can participate in a competition only if, in the period of six months prior to the competition, general health status for performing sports activities is examined. Special medical status is necessary, in addition to general medical fitness, for certain sports branches in the period of six months prior to the competition, and for certain sports branches in a shorter period, in accordance with the rules agreed by the Minister in charge of health affairs and the Minister of Youth and sport.

Assessment of the special health status of elite athletes includes: a questionnaire on the athletes’ habits; consent to access the examination; taking a detailed history of athletes; measuring body weight and height and calculating body mass index; measuring waist circumference; measuring blood pressure; physical examination by systems; electrocardiogram (12-channel ECG); laboratory tests: complete blood count (hemoglobin, hematocrit, erythrocytes, leukocytes, platelets), blood sugar, urine test (to determine the level of protein and sugar); cardiopulmonary testing if it is necessary; spiromery, echocardiography, psychological examinations, referrals to other examinations required by the rules of the competent national branch sports association; assessment of health status and assessment of risk factors for health; data entry into medical records; recording the new situation and the measures taken; registration of the rating in a sports medicine book and contest book in accordance with the law governing sports and by-laws enacted for the implementation of this law.

All these assessments can be performed in our institution by top experts in every field of medicine. If it will be necesary, the decision about athletes health, could be based on medical consilium report, which consists of professors and associates of the Medical Faculty This represents the great advantage of our center.

Estimation of the morphological status implies determination of body composition. Body composition can be estimated directly or indirectly based on anthropometric measurements. Anthropometry is a method of measuring a human body, or individual parts of the body, which quantitatively determine the morphological properties and obtain an objective picture of the state of growth of the examinee. It is applied in many areas: in sports and sports medicine, pediatrics and school medicine, for monitoring the growth of children and youth, ergonomics and industry, within standard procedures in practice, for assessment of nutrition status, as well as for scientific research of morphological characteristics of the body during growth and development.

There are various methods for assessing the morphological composition, such as measuring waist and hip circumference, waist to hip ratio, body mass index (BMI), measuring the thickness of skin folds using a caliper, bioelectric impedance, dual energy X-ray absorptiometry (DEXA scan), hydrostatic or underwater measurement, plethysmography, computerized tomography, nuclear magnetic resonance.

In our institution we use measurement of thickness of skin folds using caliper and bioelectric impedance which are standard methods for estimation of body composition.

The percentage of body fat can be precisely determined by measuring the thickness of the skin fold at the characteristic points of the body. Four places on the body are commonly used: the front of the upper arm, the back of the upper arm, below the shoulder blade on the back and on the sides above the iliac bone. Measurement of the thickness of the skin fold and subcutaneous fat tissue is done by grasping the skin fold with all the subcutaneous tissue between the thumb and forefinger of the left hand and carefully lift it above the muscular tissue, and then using the caliper (measuring instrument) the thickness of the skin fold is measured. The values obtained are put into the formula and the percentage of body fat is calculated.

This method is non-invasive, practical, simple, fast, without adverse effects and gives precise results.

The bioelectric impedance method evaluates the body composition by emitting a low and completely safe electric current through a human organism. The current passes through the body, almost without resistance through the muscles, while certain resistance exists when it passes through the fat tissue. This resistance is called bioelectric impedance and is measured using specialized scales. When it is adjusted for the selected individual (height and weight), the device based on the installed software calculates the percentage content of fat and muscle in the structure of the body composition.

The bioelectric impedance analysis is a fast, non-invasive, very precise and relatively inexpensive method for assessing body composition in both clinical and field conditions. This method does not require expensive equipment or trained technicians, it is the most comfortable method that does not jeopardize the privacy and intimacy of the measured person, and it can be used in very obese people.

Spirometry is a test frequently used for testing lung function. It is a straightforward, quick, and painless test that measures the volume of air that the test subject can inhale and exhale to and from the lungs. It is used in monitoring asthma, chronic obstructive pulmonary disease (COPD), as well as other pulmonary diseases. The test lasts approximately 15 minutes.

Spirometry is a test performed by breathing in a pipe connected to a device called “spirometer”. A medical worker will give you detailed information before you start the test to explain the appropriate technique for performing the test. It is necessary that you carefully listen to the instructions and it is encouraged that you ask questions if something is not clear. The correct technique for performing the test is necessary so that the results would be accurate. During the examination, you shall be seated on a chair. A medical worker will put a clip on your nose. You will be linked to the apparatus (spirometer) via the “mouthpiece” of the tube (plastic or cardboard), which is changed after each respondent. The mouthpiece must be sealed with lips so that the tongue does touch or enter the mouth of the mouthpiece, and so that the air does not come out of the mouth and tubes as you breathe. Firstly you will calmly breathe through the mouthpiece. Nextly, the medical worker will ask you to calmly blow out all the air from the lungs, inhale maximally, hold your breath, tighten your lips tightly on the mouthpiece, and to rapidly and forcefully exhale all the air in the lungs (until the lungs are completely “emptied”). Afterwards, you may breathe normally and rest. In order to obtain the most accurate results, the test shall be repeated three times.

Preparation for the test:
• It is necessary to omit certain medications before this examination if your doctor emphasized so (short-acting ß2-agonists should be omitted 6 hours before spirometry, long-acting ß2 agonists for 12 hours, Ipratropium and Phenoterol for 6 hours, and Tiotropium for 24 hours).
• Dress comfortably in clothes that will allow you to carry out the test easily.
• Do not have a sizable meal before spirometry.

The ergometry (load test, ergometric test) is a non-invasive cardiac method which indirectly examines the condition and functional ability of blood vessels that bring blood into heart muscle. This is a mandatory diagnostic method that sets the diagnosis of ischemic heart muscle disease.

The test is considered when you are involved in sports in order to assess the condition of your cardiovascular system, or when a doctor, based off a conversation with you and a clinical examination, raised a suspicion of a disease of blood vessels of the heart i.e., coronary disease. The test is also performed for the following reasons:
1. Evaluation of prognosis, therapy and rehabilitation of patients with coronary disease
2. Evaluation of the results of surgical procedures on coronary arteries and valves
3. Removing of coronary disease from endangered persons from otherwise asymptomatic population
4. Determining the ability for professional work, recreation and sports activities
5. Prognosis of the disease in patients with ischemic heart disease based on the load test
6. The results of the load test are an important factor in the selection of patients for the surgeon revascularization of the myocardium and evaluation of the success of the operation
Ergometry, as an unspecified test, can also be used to assess the physical abilities of patients with ischemic heart disease.
The following conditions must also be met for the performance of the ergometry:
1.That the patient can walk along the treadmill
2.That the patient has well-regulated blood pressure
3.That the patient has no test contraindications which the cardiologist assesses during the basic examination.

An ergometric test is performed in a comfortable, warm and quiet room in the presence of a doctor and a medical technician. After the clothes are removed from above the waist, the electrodes are stuck to the chest for a continuous recording of the electrocardiogram, a shortened ECG, and a blood pressure measurement via cuff strapped onto the upper arm.
On the treadmill, you will run or drive an ergobicycle according to a program that is determined according to your age, sex and body weight, with continuous monitoring of blood pressure and ECG monitoring. The test is cancelled at the end of the program, but may also be cancelled beforehand in which the doctor deems appropriate. The test lasts between 15 and 30 minutes.
Occasionally, the doctor will require re-recording of ECG or extraction blood for certain searches.
Potentional risk:
During the test, chest pains are possible as a result of a reduced infusion of oxygen to the heart muscle. The reason for this may be the narrowing of the heart arteries or their sudden clotting. Also possible is the development of cardiac arrhythmias. During the test, a sudden increase in pressure or pulse may occur. In these cases, the doctor will interrupt the test, and react accordingly so that your safety will not be compromised in any way. Upon completion of the test, it is also possible to experience a sudden drop in pressure, the onset of cardiac arrhythmias or severe sweating. And in that case, our expert medical team will undertake procedures with the goal of removing these complications.

Bring lightweight, comfortable clothes as well as clothing for exercise training.
Do not intake food, drink, caffeine or cigarettes for at least 3 hours before the test.
If you use some medication, abstain from groups of beta-blockers, calcium antagonists, nitrates and digoxin for at least 24 to 48 hours before test taking.

Ergospirometry (Cardiopulmonary exercise testingv – CPET) is a diagnostic procedure for continuous monitoring of respiratory functions and analysis of gases during physical activity, while simultaneously monitoring and evaluating heart rate at load. This test allows estimating the function and capacity of the cardiovascular, respiratory and metabolic systems. Ergospirometry is used in a variety of medical settings and disciplines such as sports medicine, cardiology and pulmonology. It is used for the purpose of diagnostics, prevention, therapy and rehabilitation.

1. It is performed for:
2. Assessment of functional capacity of athletes
3. Determination of absolute or relative contraindication to deal with physical activity
4. Determination of individual pulse training zones
5. Determining the type, intensity and scope of training to achieve the desired goals as effectively as possible
6. Tracking the effects of training
7. Determination of coronary and respiratory reserve in patients with different types of heart weaknesses
8. Diagnostic evaluation of patients with lung diseases Determination of functional capacity of patients after heart and lung transplantation
9. It is also recommended for patients with unexplained sense of lack of air (dyspnoea), when it is possible to estimate more accurately whether it is due to cardiac or pulmonary disease.

Ergospirometric test is performed in a comfortable, warm and quiet room in the presence of a doctor and a medical technician. After the clothes are removed from above the waist, the electrodes are stuck to the chest for continuous recording of electrocardiogram, shortened ECG, a special mask for extinguishing gases is placed over your face, and a blood pressure measurement via cuff strapped onto the upper arm.

You will run on a treadmill or drive an ergobicycle with continuous ECG monitoring and measuring blood pressure at the end of each degree. It is continuously monitored during the test and gas exchange estimates the consumption of oxygen (cardiovascular system) and the elimination of carbon dioxide as well as changes in ventilation parameters and respiratory system (respiratory system). The test is finished at the end of the program, but may also be finished earlier if the doctor determines so. The test itself lasts between 15 and 30 minutes.

Potentional risk:
During the test there may be chest pain, arrhythmias, leg pain, a feeling of difficulty breathing, a drop in or inadequate blood pressure, and electrocardiographic changes– but serious cardiovascular incidents are rare.

Bring lightweight, comfortable clothes as well as clothing for exercise training.
Do not intake food, drink, caffeine or cigarettes for at least 3 hours before the test.
If you use some medication, abstain from groups of beta-blockers, calcium antagonists, nitrates and digoxin for at least 24 to 48 hours before test taking.

ECHO examination of heart (echocardiography of the heart, ultrasound of the heart) is oneof the non-invasive methods for assessing cardiac function and morphology. Heart Doppler Ultrasound provides many information about the heart and heart structures, such as: dimensions of the heart cavity, heart muscle dimensions, its mobility, ejection fraction (EF), heart valve function, condition of the pericardium (heartburn). The color Doppler method provides information on the blood flow rate over the heart’s valves and diagnosis of inborn or acquired heart defects.

This examination is necessary for patients with suspected or already diagnosed cardiovascular disease (elevated blood pressure, irregular heartbeat, chest pain, fatigue, episodes of loss of consciousness, diabetics, and patients on chemotherapy or radiotherapy), it is also necessary as preventive treatment for persons with family and personal high risk factors for cardiovascular disease (obesity, smoking, increased fats in the blood, physical inactivity). On the other hand, ECHO examination of heart is recommended for all individuals who participate in a recreational or competitive sport.

The examination is completely painless, no special preparation is needed prior to examination, there are no adverse effects of this examination, and it can be applied at all ages in an unlimited number of times. It gives very precise information about the function and morphology of the heart. This examination is done in short time period (20 to 30 minutes), after which the patient immediately receives an explanation and a written report.

Measuring of heart electrical activity and blood pressure represents basic examination of cardiovascular system. Holter ECG is a diagnostic method used to monitor the activity of patient’s heart for 24 hour by small mobile device and blood pressure holter represents 24 hour measurement of arterial blood pressure.

Heart rhythm disorders and changes in blood pressure can appear periodically during day considering that many factors can affect these parameters: part of the day, physical activity, strong positive and negative emotions. Advantage of holter ECG method in comparison with standard ECG (which records heart activity for about 10 minutes on average) is higher probability of detecting heart activity disorders. Methods are comfortable, painless and are not risky for health. Based on holter ECG and holter blood pressure results our experts can observe functionality of your heart muscle and levels of your blood pressure during your common daily activities.

Abdominal ultrasound scan is a method that provides a detailed insight in size and structure of liver, pancreas, bile tract (gallbladder and bile ducts), kidneys, suprarenal glands and big blood vessels in abdomen. Because of simplicity and harmlessness of examination, abdominal ultrasound represents reliable and effective method in detecting and monitoring a variety of abdominal organs diseases, but the examination can also be performed as a preventive method in routine physical examination.

Abdominal ultrasound scan is indicated if there are present: abdominal or back pain, nausea, vomiting, rapid increasing of abdomen, abdominal injuries, rapid loss of body weight or fever of unknown origin.

Abdominal ultrasound scan can detect: acute and chronic inflammation, benign and malignant tumors, cysts, cirrhosis of the liver, presence of calculii in gallbladder and kidneys, presence of free fluid in abdominal cavity, aneurysms (bulging) and atherosclerotic plaques (lipid deposits) in large blood vessels, injuries and congenital anomalies.

Ultrasound scan of thyroid gland gives reliable information about size, consistency and potential presence of structural changes in thyroid gland tissue, characteristics fo parathyroid glands and surrounding soft tissue and using the color Doppler method the perfusion of examined organs can be visualized.

Ultrasound scan is painless, simple and it is usually done in 10-30 minutes. Doctor analyzes and writes clinical finding with description of healthy organs and detected changes in organs, gives diagnosis if the changes are present, gives advice and instruction for further diagnostic methods and gives ultrasound image as a medical document.

Ultrasound scan of soft tissues is diagnostic method that detects changes in structures of musculoskeletal system.

Ultrasound scan of soft tissues is indicated to be performed when the injuries and pain are present and doctor considers that they are caused by changes in muscles, tendons, ligaments or other structures of musculoskeletal system.

Before the scan is performed, the zones of interest have to be lubricated with gel, which enables better flow of ultrasound waves through skin. The ultrasound probe emits high frequency ultrasound waves that pass through tissues, reflects with different velocity, go back to probe and visualize on monitor. method is comfortable, painless and is not risky for health.

Soft tissue ultrasound scan can detect a variety of disorders:
• Rupture and inflammation of tendons
• Rupture of muscles, fluid collections in muscle
• Stretch and rupture of ligaments
• Inflammation and bursal effusion
• Early changes in rheumatoid arthritis
• Clumping of nerves
• Benign and malignant tumors of soft tissues
• Ganglion cysts
• Rupture of muscle fascia (muscle strain/tear)
• Foreign body in soft tissues (wood, metal or glass pieces)

Athletes’ training can be assessed by determining the anaerobic threshold by monitoring the level of lactate in the blood. The importance of determining the anaerobic threshold in functional diagnostics and its practical implementation is of great importance. The anaerobic threshold represents the highest sustainable intensity of physical activity in which the measured oxygen consumption fully meets the energy requirements of the organism. In sports training, the anaerobic threshold can be used for training adaptation monitoring, adjustment the training intensity, and in the selection of talents for sports in which general aerobic endurance dominates.

In our institution is available an easily feasible and reliable method for determining an individual anaerobic threshold based on lactate values in the blood. The test is performed normally on a bicycle-ergometer with increase in load every 5 minutes, with a pause between 30s for sampling. So, blood samples from the finger or earlobe are taken: at rest, at the end of each load level in pause up to 30 sec and at the end of the test (estimation of recovery rate). The lactate blood concentration is interpreted as a direct indicator of anaerobic metabolism in the muscles. The concentration of lactate can be obtained very easily using a lactate analyzer that is very reliable and gives results in a short period of time. Just a couple of drops of blood from your finger is enough. Lactate blood level of 4 mmol/L is taken as a anaerobic threshold (higher lactate values represent anaerobic area).
By additional measurement of the heart rate with the lactate concentration we obtain a complete and accurate response of the organism to the load. At the same time, we get the answer to the question: Does an athlete train in an aerobic or anaerobic zone? Trained athletes at the same load level have a lower heart rate and reach the anaerobic threshold later (at higher load) than non-treated.

Field testing represent a set of functional and skill tests that we can implement in the environment and conditions that our clients specifically require. These tests include detailed anthropomorphology and biochemical analyzes, power estimation, coordination of the speed, balance, precision and flexibility of movement, maximal and sub-maximal physical cardiopulmonary exercise test.

Our clients have at their disposal modern, portable equipment and our expert team, that performs testing in a very reliable manner. These tests can be accurately performed outside the laboratory, under the conditions that the client requires. This type of testing can be applied to the populations of elite and recreational athletes who want to measure the achievements within conditions in which they train each day.

In addition to high-end, modern and portable equipment, the members of our team represent the great advantage of our center, which consists of professors and associates of the Medical Faculty, University of Belgrade, specialists in sports medicine and clinical biochemistry.

Oligoelements are minerals that are present in the body in small concentrations, and are necessary for its normal functioning. The most important oligoelements are iron, zinc, manganese, fluoride, iodine, copper, molybdenum, nickel, cobalt, chromium and selenium. During physical activity, many physiological processes, such as oxygen transfer, nerve impulses transmition and muscle contraction, are intensified, while the loss of oligoelements necessary for their development increases. Therefore, certain oligoelements including iron, chromium, zinc, selenium are among the most popular nutritional supplements in athletes

Iron: It affects the capacity of oxygen transmission during physical activity. It is a mineral with the most powerful effect on sports performance, whose deficiency most often leads to anemia and increased muscle fatigue, with loss of concentration and motivation. The lack of iron in athletes occurs due to insufficient food intake, as well as through excessive sweating or during menstrual bleeding.
Zinc: More than a half of the total zinc in the body is found in muscles, therefore it plays a key role in the production of energy and protection against oxidative stress during physical activity. In athletes, intense physical activity, especially at high temperatures, additionally potentiates deficits due to loss from damaged muscle cells, through sweating and urine excretion, which can cause weight loss, fatigue and reduced endurance.
Selenium: Selenium participates in many of the enzymatic reactions of our organism, with the greatest importance in defending against the harmful effects of free radicals. Its deficiency causes muscle damage and insufficient immune response.

The content of oligoelements is determined by blood analysis. Based on the results of your analysis, our team of physicians assesses whether there is a need to correct one of the elements.

Vitamins are organic compounds necessary for the normal metabolism, which must be ingested by food, because they are produced in organism in small quantities, or not produced at all. It is known that physical activity increases the intensity of metabolism, which is why lack of some vitamins during sports activities adversely affects sports performance and requires supplementation. However, even without a defined deficit, athletes very often use (multi) vitamin preparations as dietary supplements, especially vitamins A, B groups, C, D and E.
Vitamin A: A significant place in sport belongs to β-carotene – a precursor of vitamin A. It is known for its antioxidant properties and could protect the body from free radicals that are amplified during intense training.
Vitamin B groups: Physical activity reduces the concentration of some vitamins such as thiamine, riboflavin and pyridoxine, most likely by reducing the absorption in the intestine and increasing excretion, as well as intensifying consumption by activating metabolism. Another problem is the insufficient food intake in athletes on a low calorie diet. The lack of vitamin B group aggravates sports performance and complicates relaxation of muscles, especially at maximum physical effort.
Vitamin C: Vitamin C is a key factor for the synthesis and proliferation of collagen, and to a large extent determines the strength and durability of the subcutaneous tissue, cartilage, bones and teeth. Its deficiency could cause bleeding in the skin, the gingives and the joints, and slow the healing of the wound.
Vitamin D: Regulates calcium circulation in the body, accelerating its incorporation into the bones. Deficiency of this vitamin is very often present among athletes, especially younger women, in which it leads to muscle weakness and represents a significant risk of bone fractures during training.

Vitamin content is determined by blood analysis. Based on the results of your analysis, our team of physicians assesses whether there is a deficiency of some vitamin and suggests solutions for adequate compensation.

In the course of metabolic processes in which oxygen is necesarry, an enormous number of products are produced, called “free radicals”, which are able to damage the various cellular components. In order to protect itself, every living oranism has created a very complex “antioxidant” protection system. Its basic role is to maintain a balance between the free radical oxidation process (oxidants) and the antioxidant protection system. Thus, normal metabolic processes produce always free radicals, which the organism can control with antioxidants. However, imbalance can occur either due to lack of antioxidants or due to the abundance of free radicals. But if the oxidation process becomes dominant (for example, due to smoking, intense sunbathing, etc.), the antioxidant system can not protect the body. Any shift of balance in favor of free radicals, which favors oxidation, leads to cell damage and is called “oxidative stress”. Oxidative stress plays a major role in the development and development of cardiovascular and infectious diseases, carcinoma, diabetes, neurodegenerative and locomotor disorders such as Alzheimer’s and Parkinson’s disease, urogenital and digestive diseases, and in the aging process. Therefore, the assessment of the state of health based on the measurement of the level of oxidative stress, is of great importance for the prevention of the disease, prevention of further complications in the case of already existing chronic diseases, as well as the overall improvement of health.

By measuring the level of some substances in the serum or plasma, which can be parts of the protective, antioxidant system, or products that result from the damaging of certain cellular components under the action of free radicals, the current state can be assessed and timely measures taken to prevent the disease are taken. There is a whole series of tests, which determines: the total antioxidant status, as well as the level of individual enzymes (glutathione peroxidase, glutathione reductase, superoxide dismutase). By combining the results of these tests, it is possible to determine at what site the body has undergone a change and which organ is compromised. This is particularly important in routine health assessment, since changes can be detected even before the disease develops. Testing of the antioxidant status is also used in diseased persons, in order to monitor changes in the condition of the disease, the effects of the therapy, etc.

Determination of the oxidative status of the organism is especially recommended for healthy persons who are exposed to increased psychological or physical stress, such as businessmen, students, athletes, smokers, patients after the application of certain therapeutic procedures, etc. The recommendation of the experts is that all risk groups carry out these tests once or twice a year in order to prevent the disease.
If a deviation from the defined limits is found, it is necessary to change the rhythm of life, the regime and diet, more rest and possibly taking dietary supplements containing appropriate antioxidants. In this way, it is possible to restore the balance in the organism and the normal functioning of the protective system, which is a prerequisite for good health.

Assessment of nutrition is a set of anthropomorphology and biochemical tests that assess the relationship between energy input and consumption in different human populations and its impact on body composition.

After a detailed conversation with our clients about their daily eating habits and the physical activity they deal with, we approach detailed measurements using a stadiometer, calipers and a bio-impedance analyzer for the body composition, to determine the detailed anthropomorphology status. The last step is the biochemical analysis of the blood, which determines the level of electrolytes and oligoelements.

Using the data obtained from these analyzes, the members of our expert team, consisting of professors and associates of the Faculty of Medicine, University of Belgrade, specialists in clinical biochemistry, sports medicine and subspecialists in the field of nutrition, provide our clients an adequate advice on nutrition. Advices are directed eider to increment/redocument or maintenance of current nutrition, depending on the needs of our clients.

Specificity of training in the population of elite and recreational athletes cause the specific energy requirements of their body. Even when we look at team sports, playing in different team positions requires a different type of training and therefore a different energy consumption. It is very important that an athlete follows an adequate nutrition program, which will ensure that all his needs for hydration, macro and micronutrients are satisfied. Therefore, it is necessary to provide an individual nutrition plan for each athlete, with the design of a daily menu that can meet all the athlete’s energy needs.

The members of our expert team use detailed anthropomorphology and biochemical tests to prescribe an individually adjusted nutrition and supplement program for the athlete. After a detailed discussion of everyday eating habits and the type of training that they carry out daily, we approach detailed measurements using a stadiometer, calipers and a bio-impedance analyzer for the body composition, to determine the detailed anthropomorphology status. The last step is the biochemical analysis of the blood, which determines the level of electrolytes and oligoelements.

Specificity of training in the population of elite and recreational athletes cause the specific energy requirements of their body. Even when we look at team sports, playing in different team positions requires a different type of training and therefore a different energy consumption. It is very important that an athlete follows an adequate nutrition program, which will ensure that all his needs for hydration, macro and micronutrients are satisfied. Therefore, it is necessary to provide an individual nutrition plan for each athlete, with the design of a daily menu that can meet all the athlete’s energy needs.

The members of our expert team use detailed anthropomorphology and biochemical tests to prescribe an individually adjusted nutrition and supplement program for the athlete. After a detailed discussion of everyday eating habits and the type of training that they carry out daily, we approach detailed measurements using a stadiometer, calipers and a bio-impedance analyzer for the body composition, to determine the detailed anthropomorphology status. The last step is the biochemical analysis of the blood, which determines the level of electrolytes and oligoelements.

In our center, we offer the opportunity for all future clients to cooperate individually with our expert team comprised of professors and associates of the Faculty of Medicine, University of Belgrade, specialists in clinical biochemistry, sports medicine and subspecialists in the field of nutrition. Members of our expert team use detailed anthropomorphology and biochemical tests to prescribe an individually designed nutrition and supplementation program for an athlete, that will help our clients to preserve and improve their health, prevent the occurrence of illness and improve their training performance.

The prolongation of the life-span of people is also followed by an increasing percentage of the population suffering from chronic non-communicable diseases. In the Republic of Serbia, the percentage of patients with hypertension is over 40%, while about 8% of the population suffers from diabetes. The focus of the prevention of chronic noncommunicable diseases, but also the first line of their therapy represents it an adequate hygienic and dietetic regime. Our center offers the patients suffering from various chronic noncommunicable diseases the design of a daily diet plan and menu, that will slow down the further development of their chronic disease.

Each patient is individually accessed by our expert team consisting of professors and associates of the Medical Faculty, the University of Belgrade, specialists in internal medicine, sports medicine and subspecialists in the field of nutrition. After a detailed informative discussion, physical examination and biochemical analyzes, our team members design few examples of a daily menu, that can be apply daily in accordance with his socio-economic status and eating habits of our patients.

In our center we offer the opportunity to patients with various chronic non-communicable diseases to individually cooperate with the most eminent experts in the respective fields of medicine. In this way, we guarantee patients the best possible treatment.

Today, the importance of physical activity in preventive and therapeutic purposes is emphasized, and the used term is that exercise is a cure. So we can say that physical activity is “polyiphil”, which not only treats different diseases, but also contributes to a better therapeutic effect of other drugs. In order to achieve its positive effect on the prevention and treatment of the disease, it must be properly dosed, as any medicine. In this sense, it is extremely important to be dosed individually.
In our institution at the Faculty of Medicine, a group of experts, professors of our faculty, will compile a program of physical activity based on your health status and recommendations from various associations. This is the service you can only get in our institution.

You will get a physical activity program, seven days per week, with various types of physical activity, all in line with your abilities and needs.
The simplest way of dosing is according to the FITT formula, which are the initial letters of: Frequency, Intensity, Time, and Type. Today, you can often find the abbreviation VPP principle, which is the abbreviation of Volume, Pattern (principle) and Progression.

The prevention of chronic non-communicable diseases is the imperative of modern society and medicine. Physical activity is in the centre of this strategy because of its positive benefits to the health of an individual. Today it is known that it is necessary to dosage physical activity in order to prevent specific diseases such as hypertension, diabetes mellitus, metabolic syndrome, depression, but also many other diseases. In that sense, it is necessary to give a proposal on the type of physical activity, duration, intensity, frequency.
In our institution at the Faculty of Medicine you can get a program of exercise individually dosed according to age, gender, everyday habits. The uniqueness of our faculty is that this service is provided exclusively by professors, experts in this field.

Maximum heart rate (HR max) is the most commonly used parameter in everyday practice, due to its exceptional simplicity. It is estimated as 220 minus one’s age. Target heart rate, the work area that contributes to the preservation and improvement of health is 55 -89% HRmax. It is important to note that, in practice, there are modifications of this formula (for example, for female females, physically active persons) because it equates all persons for whom it is calculated, without taking into account any individual parameter.
Heart rate reserve (HRR) or Karvonen method is a reliable and precise method of dosing, but it also requires knowledge of individual morning HR frequency (usually measured three consecutive mornings and takes the mean value). According to this method, at the calculated target heart rate someone should do exercise in a mode of work that contributes to the preservation and improvement of health.

It is an examination of at least three top experts from the field, teachers of the Medical Faculty. It is organized when the opinion of one specialist is not sufficient.

Since the Faculty of Medicine in Belgrade employs experts from various fields, the specialty of our institution is, in fact, the possibility of organizing the Consilium. This is especially important for top athletes with a health problem in order to obtain a license for active sports.

An examination performed by a psychiatric specialist with a psychiatric interview. Obtaining precise data on client’s subjective difficulties and preliminary evaluation of mental status. Evaluation of cognitive abilities, motivation, and state of consciousness. Determination of the appropriate diagnosis and advice on pharmacotherapy or psychotherapy. If the psychiatrist and client opt for pharmacotherapy, the medication should achieve the greatest effect with the least potential adverse effects. If it is estimated that psychotherapy is needed, the form of psychotherapy that is indicated for diagnosed mental disorder is chosen, but also the one which at the moment most suits the client in the light of his current abilities, attitudes and affinities. Psychotherapy can also help mentally healthy people who want to actively work to improve their mental health and mental capacity to deal with daily stress factors.

Psychoeducation is intended for clients with psychiatric disorders, as well as healthy people who want to learn more about psychiatry as a discipline, and about certain mental disorders. Sometimes, psycho-education can itself have a psychotherapeutic effect. In this way, clients are educated in a way to, most adequately, protect and preserve their mental health, as well as to recognize the disease when it is at the beginning. Psychoeducation can also be useful for family members of the client diagnosed with a mental disorder and in this way increase the level of family and wider social support for the client.

A specific type of therapy in psychiatry where the primary goal is to increase the level of motivation. Especially suitable for professional athletes who, because of psychological reasons/circumstances, have poorer results in sports competitions. Motivational therapy can also be applied in people where one of the main symptoms is the lack of will. This symptom, among other things, is very commonly seen in depression, neurasthenia, anxiety disorders and addiction. Motivational therapy can also be used to prevent, or preserve, mental health.

Kinesiotherapy refers to treatment through movement. It implies the application of movements for the treatment of diseases and injuries of the bone-muscle system, as well as for the prevention of the development of various pathological conditions. The bone-muscle system can be damaged due to various acquired conditions, congenital anomalies or injuries. The movement that represents the basis of kinesiotherapy can be active, assisted or passive. With physical effort during the kinesiotherapy there are changes in the respiratory, cardiovascular and nervous system.
The goal of kinesiotherapy is to restore a healthy, physiological movement, improve the impaired mobility and function of the bone-muscular system, and encourage the motor development of children. Properly performed kinesiotherapy has no side effects and can be applied at all ages.

It is applied to various disorders of the skeleton-muscular system, such as: painful spinal column syndromes (neck pain or lumbar spine), scoliosis, kyphosis, post-traumatic conditions, and postoperative conditions.

In our center it is possible to apply both individual and group kinesitherapy.

In individual kinesiotherapy, exercises are fully adapted to the patient. The physiotherapist devotes his attention to individual work with the patient. At each stage of this therapy, he monitors the range of patient movement, the presence of pain or some other complications.
It is suitable for rheumatic, neurological, orthopedic patients, for working with children with developmental difficulties, for oncological patients (conditions after mastectomy, laryngotomy, etc.), as well as for all healthy individuals who want to improve their fitness

Kinesiotherapy refers to treatment through movement. It implies the application of movements for the treatment of diseases and injuries of the bone-muscle system, as well as for the prevention of the development of various pathological conditions. The bone-muscle system can be damaged due to various acquired conditions, congenital anomalies or injuries. The movement that represents the basis of kinesiotherapy can be active, assisted or passive. With physical effort during the kinesiotherapy there are changes in the respiratory, cardiovascular and nervous system.
The goal of kinesiotherapy is to restore a healthy, physiological movement, improve the impaired mobility and function of the bone-muscular system, and encourage the motor development of children. Properly performed kinesiotherapy has no side effects and can be applied at all ages.

It is applied to various disorders of the skeleton-muscular system, such as: painful spinal column syndromes (neck pain or lumbar spine), scoliosis, kyphosis, post-traumatic conditions, and postoperative conditions.

In our center it is possible to apply both individual and group kinesitherapy.

Group kinesiotherapy is applied in smaller groups of 3-4 patients who have the same disorders (e.g. pain in the lumbar spine, dizziness or osteoporosis). In such therapy, patients with the same problems can understand and support each other, as well as share their experiences and advice. At any time, the patients are under the supervision of a physiotherapist who monitors their work and progress. It is suitable for chronic patients whose health status meets the work in the group as well as for all healthy individuals who want to improve and preserve their fitness.

Kineziotaping is a special therapeutic technique for applying elastic tape. Tape is applied with the goal of relieving a certain muscle or part of the body or, in contrast, to stimulate the function of a muscle(s). The kinesio tape has no task of immobilization, but it allows movement.

It is performed for:

1.Muscle support:
Improves contraction of weak muscles, reduces muscle fatigue, reduces cramping and muscle tension, increases the range of motion
2.Reduce the swelling of tissue and muscle tissue:
Improves blood and lymph circulation, reduces heat and muscle tissue toxicity, and reduces inflammation
3.Reduces pain:
It activates the spinal blockade of pain, activates brain blockade of pain, and reduces muscle tension
4.Corrects problems with the joints:
It corrects the contact of the joint surfaces, normalizes the muscle tone and tension in the joint, improves range of motion, relieves pain
The indications for performing kineziotaping are sports injuries, painful conditions of the spinal cord and lumbalgia, a pulled muscle, tendon inflammation, and or joint pain (shoulders, knees, hands, feet).

Kineziotaping is set according to certain principles, taking into account muscle anatomy and joints, the types of injuries and diseases, and especially with regard to the kinesiological principles of movement to a certain part of the body. A skilled physiotherapist and doctor will apply your tapes in a specific place(s). Tapes after application will stay on your body for 2-5 days. The tape is waterproof and anti allergenic. There are various colors and degrees of elasticity.

Potentional risk:
There are no potential risks from the practice of kineziotaping.

Preparation for testing:
There is no special preparation for kineziotaping. Occasionally, it is necessary to remove excess hair.

Based on the performed medical examinations, an assessment of the health status and physical fitness for participation in sports competitions within a certain sports branch or sports discipline will be given. This assessment must be entered in the competition booklet, signed and certified by an authorized doctor, with his facsimile and seal. The advantage of our institution is that these reviews and final opinion are given by the professors of the Medical Faculty.