The Rising Incidence and Mortality of Prostate Cancer in Belgrade Population

The purpose of this study was to analyze the epidemiological situation of prostate cancer in Belgrade population. Morbidity data were obtained from the Institute of Public Health of Serbia for the period 1999–2005. Mortality data for the period 1990–2006, were derived from the Statistical Office of Republic of Serbia. Average standardized incidence and mortality rates for the prostate cancer were 33.57 and 11.86 respectively. Standardized incidence rates of prostate cancer steadily increased from 29.34 per 100,000 in 1999 to 36.86 per 100,000 in 2005. In the observed period, the mortality rates significantly increased in the age groups 50–59 (y=2.77+0.42x, p=0.015), 70–79 (y=61.92+10.70x, p=0.000) and 80+ (y= 183.08+19.99x, p=0.000). The average annual percentage of changes (AAPC) was the highest (7.2%) for the 70–79 age group, the lowest (0.1%) for the youngest group(50), and 5% for the total. The increase of prostate cancer incidence and mortality during the observed period in Belgrade population indicate urgent need for Serbian health professionals to adopt existing evidence-based cancer control and preventive measures. A national policy including prostate specific antigen (PSA) screening should be considered

Oesophageal-cancer-derived death in the population of Belgrade in a period 1989-2006

Background/Aim. Oesophageal cancer is the sixth most common cause of death from all malignant tumors in the world (fifth in men, eighth in women). This cancer was estimated to account for about 529 000 new cases and about 442 000 deaths in the year 2007. In the year 2002 the highest standardized mortality rates (per 100 000 habitants) of oesophageal carcinoma were noticed in the East Asia (men/women: 18.8/7.7) and East Africa (18.6/7.8), while the lowest were noticed in the Middle Africa (1.4/0.2) and West Africa (1.3/0.5). The aim of this descriptive epidemiologic study was to analyze epidemiologic situation of oesophageal cancer in Belgrade population during the period 1989-2006, using mortality data. Methods. Mortality data were collected from the City Organization for Statistics. In data analysis we used mortality rates which were standardized directly using those of the world population as the standard, and proportions. A denominator for mortality rates was calculated using the Belgrade population which was an average of the two latest register years (1991 and 2002). In order to analyze trend mortality from oesophageal cancer we used linear trend. Results. In Belgrade deaths from oesophageal cancer accounted for about 5.2% of all malignant tumors of intestinal system in male population, and 2.4% in female population. This cancer is, according to standardized mortality rates (per 100 000 habitants), on the fifth place in Belgrade population behind colorectal, stomach, pancreatic, liver and cholecystic cancer. During the period 1989-2006 in Belgrade 44 persons died from oesophageal carcinoma on the average each year, mainly men (75%), and the rest were women (25%). In male population during the same period we noticed a significant increase in trend mortality (y = 1.61 + 0.06x, p = 0.001), while in female population the increase of mortality was not significant. The male/female oesophageal cancer mortality ratio was 3:1. Mortality rates for oesophageal cancer rise with age in both sexes and they are highest in the age group of 70 and more years. Significant increase in mortality from oesophageal cancer was noticed in age groups 20-29 and over 70 in male population, and age group 40-49 in female population. Conclusion. Increasing trend in oesophageal mortality suggests the necessity for improving measures of primary prevention including education about risk factors for this carcinoma (smoking, alcohol consumption, hot food and drinks), early diagnosis, and treatment

Gender Differences in Relation to Knowledge and Risky Behavior among Students of Medical Colleges in Serbia: Study of Prevalence

The aim of this study was to determine the level of knowledge about sexually transmitted diseases and the frequency of behavior presenting risk for acquiring those diseases among students of Medical colleges in relation to gender. The study is based on a cross-sectional survey conducted in two Medical colleges in Belgrade in December 2016. A total of 670 students (96%) completed an epidemiological questionnaire. Respondents were selected through random sampling, they took part in the study voluntarily and filled in the questionnaire anonymously and independently. The questionnaire included 18 questions on demographic characteristics, knowledge and risky behavior. Female students were significantly older than male students (p= 0.014). Male students were more often single, while female students were mostly in the relationship or married (p< 0.001). Female students have more knowledge about symptoms of sexually transmitted diseases (p= 0.008) and more than males are familiar with the causality of HPV infection and cervical cancer (p= 0.002). Males students earlier had the first sexual intercourse (p< 0.001), had sex on the first date (p< 0.001), changed sexual partners during their lives (p< 0.001), and paid for sex (p< 0.001). Male students have specific risk factors for unhealthy sexual behavior. It is necessary to upgrade the education programs and implement population-targeted prevention and control measures for sexually transmitted infections

Grejvs-Bazedovljeva bolest i potencijalni faktori rizika

Background/Aim. Graves-Basedow disease is a common multifactorial genetic syndrome, which is determined by several genes and environmental factors. The aim of the present study was to investigate the presence of risk factors for developing Graves-Basedow disease between the groups of individuals with and without Graves-Basedow disease, and to compare the presence of risk factors between the affected individuals with or without positive family history for Graves- Basedow disease. Methods. This cross-sectional study was conducted in Ćuprija (central Serbia) during a period from December 2001 to April 2002. The case group comprised 132 individuals diagnosed with Graves-Basedow disease. The control group comprised 130 subjects without any of endocrine diseases. All participants were interviewed at the Medical Center Ćuprija using structural questionnaire. Data were collected on basic demographic characteristics, exposure to various chemical and physical agents, stress, smoking and family history of Graves-Basedow disease. In statistical analysis chi-square test was used. Results. The individuals with Graves-Basedow disease were statistically significantly older (above 50) (p = 0.020), exposed to stress (p = 0.024) and to physical agents (p = 0.031), and had significantly (p = 0.000) more relatives with Graves-Basedow disease than those without the disease. Among the affected individuals with positive family history of Graves-Basedow disease the number of women was significantly higher (p = 0.000), than the affected individuals without positive family history of Graves- Basedow disease. Conclusion. In our study, as in many other, gender, age, positive family history of Graves-Basedow disease and exposure to physical agents were identified as potential risk factors for the increased incidence of Graves- Basedow disease. Different risk factors are probably responsible for developing Graves-Basedow disease among the affected individuals with or without positive family history of Graves-Basedow disease. .Uvod/Cilj. Grejvs-Bazedovljeva bolest nastaje kao rezultat interakcije između genetičkih faktora i faktora sredine. Cilj ovog rada bio je da se ispita prisustvo faktora rizika koji mogu da utiču na nastajanje Grejvs-Bazedovljeve bolesti kod populacije Pomoravskog okruga, kao i da se ispita da li postoji razlika u prisutnim faktorima rizika između obolelih od Grejvs- Bazedovljeve bolesti sa i bez pozitivne porodične anamneze ovog oboljenja. Metode. U studiju je bilo uključeno 350 osoba Pomoravskog okruga, od kojih je 132 bilo sa Grejvs- Bazedovljevom bolešću i 130 zdravih osoba, za koje je utvrđeno da nemaju endokrinološko oboljenje. U cilju procene izloženosti potencijalnim faktorima rizika od nastajanja Grejvs-Bazedovljeve bolesti koristili smo upitnik koji je sadržao pitanja koja su se odnosila na demografske karakteristike, pušenje, stres, izloženost hemijskim i fizičkim agensima na poslu i prisustvo pozitivne porodične anamneze Grejvs- Bazedovljeve bolesti za period pre dijagnostikovanja oboljenja. Rezultati. Osobe sa Grejvs-Bazedovljevom bolešću, u poređenju sa osobama bez Grejvs-Bazedovljeve bolesti, značajno češće bile su: starijeg uzrasta (50 i više godina) (p = 0,020), izložene stresu (p = 0,024) i fizičkim agensima na poslu (p = 0,031), sa pozitivnom porodičnom anamnezom Grejvs-Bazedovljeve bolesti i sa većim brojem prvo- i drugostepenih srodnika sa istim oboljenjem (p = 0,000). Oboleli od Grejvs-Bazedovljeve bolesti sa pozitivnom porodičnom anamnezom, nisu se statistički značajno razlikovali po izloženosti potencijalnim faktorima rizika u odnosu na obolele osobe bez pozitivne porodične anamneze Grejvs-Bazedovljeve bolesti, sem što su značajno češće u ovoj grupi bile žene (p = 0,000). Zaključak. Pol, uzrast, pozitivna porodična anamneza Grejvs-Bazedovljeve bolesti i izloženost fizičkim agensima identifikovani su kao potencijalni faktori rizika od Grejvs- Bazedovljeve bolesti. Različiti faktori rizika verovatno su odgovorni za nastanak Grejvs-Bazedovljeve bolesti kod obolelih osoba sa i bez pozitivne porodične istorije ovog oboljenja.

Potencijalni faktori rizika za nastajanje dijabetesa melitusa tipa 2

Introduction Type 2 diabetes mellitus is a common multifactorial genetic syndrome, which is determined by several genes and environmental factors. The aim of the present study was to investigate the presence of risk factors for developing diabetes type 2 among diabetic individuals and to compare the presence of risk factors among diabetic individuals with and without positive family history for type 2 diabetes. Material and methods This study was conducted in Cuprija during the period from February to June 2002. The case group included 137 individuals having diagnosis type 2 diabetes. The control group included 129 subjects having the following diagnoses: hypertension, angina pectoris, chronic obstructive lung disease, gastric ulcer or duodenal ulcer. All participants were interviewed at the Medical Center Cuprija using structural questionnaire. The data were collected regarding demographic characteristics, exposure to various chemical and physical agents, stress, smoking, obesity, physical inactivity and family history of diabetes. In the statistical analysis chi square test was used. Results The diabetic individuals were statistically significantly older (40 and more years old) (p=0,000), and they came from rural areas more frequently (p=0,006) than the individuals without diabetes. Significantly more diabetics had lower educational level (p=0,000) and they were agriculture workers and housewives significantly more frequently (p=0,000) than nondiabetic individuals. Furthermore, obesity (p=0,000) and physical inactivity (p=0,003) were significantly more frequent among the diabetic individuals than the nondiabetics. The diabetic individuals had significanly (p=0,000) more numbers of relatives with diabetes mellitus type 2 than the nondiabetics. The diabetic individuals with positive family history of diabetes were significantly older (p=0,021) and more frequently from urban areas (p=0,018) than the diabetic individuals without the positive family history of diabetes. Also they were significantly less exposed to physical agents (p=0,004). Discussion In our study, like in many others, age, place of residence, education, occupation, obesity, physical inactivity, positive family history of diabetes type 2 and exposure to physical agents were identified as potential risk factors for diabetes type 2. Conclusion Different risk factors are probably responsible for developing type 2 diabetes among individuals with and without positive family history of type 2 diabetes.Dijabetes tipa 2 jeste bolest koja nastaje kao rezultat interakcije genetičkih faktora i faktora sredine. Cilj ove studije bio je da se ispitaju faktori rizika koji utiču na nastajanje dijabetesa tipa 2 u populaciji Pomoravskog okruga, kao i da se analizira da li postoji razlika u faktorima rizika obolelih od dijabetesa bez pozitivne porodične anamneze i onih sa njom. U studiju je bilo uključeno 266 osoba iz Pomoravskog okruga, od kojih je 137 njih bilo sa dijabetesom melitusom tipa 2 i 129 sa nekim drugim oboljenjem (hipertenzija, angina pektoris, hronična opstruktivna bolest pluća, čir želuca ili čir dvanaestopalačnog creva). Osobe sa dijabetesom, u poređenju sa osobama bez dijabetesa, znatno su češće bile: starijeg uzrasta (40 i više godina starosti) (p=0,000), iz ruralne sredine (p=0,006), nižeg stepena obrazovanja (p=0,000), poljoprivrednici i domaćice (p=0,000), gojazne (p=0,000) i fizički neaktivne osobe (p=0,003) , a imale su i veći broj srodnika sa dijabetesom melitusom tipa 2 (p=0,000). Oboleli od dijabetesa sa pozitivnom porodičnom anamnezom za ovo oboljenje znatno su češće bile, starijeg uzrasta (p=0,021) i iz urbane sredine (p=0,018) od onih bez pozitivne porodične anamneze za dijabetes. Međutim, oboleli od dijabetesa bez pozitivne porodične anamneze za dijabetes znatno su češće (p=0,004) bili izloženi fizičkim agensima od onih koji su imali pozitivnu porodičnu anamnezu za ovo oboljenje

Značaj određivanja serumskog amiloida A i drugih reaktanata akutne faze kod ambulantnih pacijenata sa COVID-19

Background: The unpredictable course of Coronavirus Disease 19 (COVID-19) is making good severity assessment tools crucial. This study aimed to assess the usefulness of serum amyloid A (SAA) and other acute-phase reactants (APRs) in ambulatory care COVID-19 patients and identified relationships between these markers and disease outcomes. Methods: From August to November 2020, patients seen in the outpatient department of the Clinic for Infectious and Tropical Diseases (Belgrade, Serbia) with confirmed COVID-19 were included. Patients were classified into mild, moderate, and severe disease groups based on World Health Organization criteria. SAA, C-reactive protein (CRP), interleukin-6 (IL-6), procalcitonin (PCT), ferritin, fibrinogen, D-dimer, albumin, and transferrin were measured. The median values of all APRs were compared between COVID-19 severity groups, hospitalized and non-hospitalized patients, and survivors and non-survivors. The Receiver operator characteristic (ROC) curve analysis was used for the classification characteristics assessment of individual APRs for the severity of illness, hospitalization, and survival. Results: Higher levels of SAA, CRP, IL-6, PCT, and lower levels of transferrin and albumin were observed in severe cases, hospitalized patients, and non-survivors. Based on ROC curve analysis AUC for SAA has fair classification performance for disease severity (0.794) and death (0.732) and good performance for hospitalization (0.853). Conclusion: SAA is a valuable marker in everyday practice for assessing COVID-19 severity and prognosis in ambulatory patients.Uvod: Tok koronavirusne bolesti 2019 (COVID-19) je nepredvidiv, zbog čega su neophodni dobri alati za procenu težine ove infekcije. Svrha ovog istraživanja je procena značaja određivanja serumskog amiloida A (SAA) i drugih reaktanata akutne faze (RAF) kod ambulantnih pacijenata sa COVID-19, kao i identifikacija veze između ovih markera i ishoda bolesti. Metode: Od avgusta do novembra 2020. godine, u studju su uključeni pacijenti koji su pregledani u Prijemnoj ambulanti Klinike za infektivne i tropske bolesti (Beograd, Srbija), sa potvrđenim COVID-19. Pacijenti su bili klasifikovani u grupe blage, umerene i teške bolesti na osnovu kriterijuma Svetske zdravstvene organizacije. Određivane su vrednosti SAA, C-reaktivnog proteina (CRP), interleukina-6 (IL-6), prokalcitonina (PCT), feritina, fibrinogena, D-dimera, albumina i transferina. Medijane vrednosti RAF su poređene između grupa težine bolesti, bolesnika koji su bili hospitalizovani i onih koji nisu, kao i preživelih i preminulih. Korišćena je analiza Receiver operator characteristic (ROC) krive i Area-under-curve (AUC) za analizu klasifikacionih karakteristika pojedinačnih RAF za težinu bolesti, hospitalizaciju i preživljavanje. Rezultati: Viši nivoi SAA, CRP, IL-6, PCT i niži nivoi transferrina i albumina su uočeni kod osoba sa teškim oblikom bolesti, hospitalizovanih pacijenata i preminulih. Na osnovu analize ROC krive, AUC za SAA je pokazao zadovoljavajuće klasifikacione performanse za težinu bolesti (0,794) i smrtni ishod (0,732) i dobre performanse za hospitalizaciju (0,853). Zaključak: SAA je vredan marker u svakodnevnoj praksi za procenu težine i prognoze COVID-19 kod ambulantnih pacijenata

Risks for First Nonfatal Myocardial Infarction in Belgrade

The aim of this study was to investigate which one among possible risk factors are independently related to first nonfatal myocardial infarction (MI) in Belgrade population. Case-control study was conducted in Belgrade during the period 2005–2006. Case group comprised 100 subjects 35–80 years old who were hospitalized because of first nonfatal MI at the coronary care unit in Urgent Center, Belgrade. Control group consisted of 100 persons chosen among patients treated during the same period at the Institute of Rheumatology, Institute for Gastroenterology, and Clinic for Orthopedics, Belgrade, Serbia. Cases and controls were individually matched by sex, age (±2 years) and place of residence (urban/ rural communities of Belgrade). According to the multivariate analysis risk factors for MI occurrence were »good« socioeconomic conditions (OR=2.76), total alcohol consumption (OR=2.62) and consumption of brandy (OR=6.73), stressful life events taken together (OR=3.13) and stress because of close relative Ns death (OR=3.35), great financial problems (OR=31.64) and small financial problems (OR=8.47), hypertension (OR=2.39), MI among all relatives (OR=3.66), MI in father (OR=6.24), and low level of high density lipoprotein cholesterol (OR=152.41). Amateur sport activity in the past was negatively associated with MI development. The results obtained are mainly in accordance with other studies results and can be of help in development of strategy for coronary heart disease prevention in Serbia

Understanding the Male Perspective: Evaluating Quality of Life and Psychological Distress in Serbian Men Undergoing Infertility Treatment

The experience of an infertility diagnosis and treatment imposes a profound burden on affected individuals, encompassing not only physical and medical aspects but also a plethora of psychological, social, and emotional factors. By employing a multimodal assessment featuring validated self-report questionnaires, physical measurements, and clinical records, the present study aimed to explore the quality of life and psycho-emotional distress of men undergoing infertility treatment in Serbia, thereby addressing the dearth of research on the underrepresented male perspective in this domain. Findings revealed diverse semen abnormalities among participants (n = 96, average age 37.69 ± 5.72), with significant associations between longer treatment durations and reduced sperm motility. The observed rates of men surpassing predetermined DASS-42 questionnaire thresholds for depression, anxiety, and stress in the analyzed cohort were 13.54%, 11.46%, and 22.92%, respectively. Summary scores in conceptual areas comprised in the SF-36 questionnaire ranged from 49.00 ± 6.25 for the mental health dimension to 90.16 ± 17.75 obtained in the physical functioning subscale. Patients with a longer treatment duration demonstrated lower scores in the role emotional domain, indicative of a less favorable emotional state. Expectedly, inverse correlations were found between the SF-36 mental health score and DASS-42 subscales. By addressing the existing knowledge gap and highlighting the unique needs of infertile men, the finding of this study may contribute to a more inclusive and holistic approach to infertility research and management

Mucous patch on the tongue as isolated manifestation of the secondary stage of syphilis: Case report

Introduction. Syphilis is sexually transmitted infection caused by the anaerobic spirochete Treponema pallidum. Oral lesions are present and described in all stages of the disease. These lesions as well as blood and saliva of infected persons are highly contagious in early syphilis. The aim of this case report was to point out to the possibility of the secondary syphilis in differential diagnosis of oral diseases. Case Report. A 38-year-old asymptomatic man showed up at the clinic with suspicious of syphilis infection. Clinical presentation of the disease was a mucous patch on the tongue, however no other mucous membrane or cutaneous lesions were detected. No lymph nodes were enlarged. The serologic tests on syphilis were positive. After conducting systemic antibiotic therapy with benzathine penicillin the tongue lesion disappeared. Conclusion. Depending on the clinical picture, the possibility of syphilis should not be overlooked in the differential diagnosis of oral lesions

CLINICAL, DEMOGRAPHIC AND LIFESTYLE CHARACTERISTICS OF MEN WITH GENITAL LICHEN SCLEROSUS

The aim of the paper was to evaluate the clinical presentation, demographic and lifestyle characteristics of men with genital lichen sclerosus (LS). This study examined the cases of 73 men with genital LS who appeared at the City Institute for Skin and Venereal Diseases in Belgrade between January 2007 and December 2008. The diagnosis of LS was established by history and physical examination. Data about demographic and lifestyle characteristics were obtained by the use of a questionnaire. Nearly 60% of men with LS were older than 45 years. The most frequent complaint was a tight foreskin which was detected in 70% of men. White atrophic lesions, fissures and cracking were recorded in the majority of the patients. The most frequently affected site was prepuce in 76% of cases. More than 70% of participants had frequent sexual activities and 57.5% were exposed to stress. LS is disease with a wide spectrum of clinical manifestations, such as prepuce lesions, which increases the risk for acquiring some sexually transmitted pathogens. That fact stresses the importance of LS patients counseling on consistent condom use and importance of early diagnosis and early treatment which may prevent further penile lesions, complications and diminish vulnerability to sexually transmitted infections and HIV