Maternal and neonatal risk factors for childhood type 1 diabetes: a matched case-control study

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Trends in cerebrovascular diseases mortality in Serbia, 1997-2016: A nationwide descriptive study

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objectives Over the last decades, mortality from cerebrovascular diseases (CVDs) has decreased in many countries. The aim of this study was to assess the trends of CVDs mortality in Serbia. Methods Descriptive epidemiological study. Age-standardised rates (ASRs) for CVDs mortality were assessed by joinpoint regression analysis to identify significant changes in trends and estimate annual per cent changes with 95% CI. The age-period-cohort analysis has been used to describe variations in mortality. Results Over this 20-year period, there were 312 847 deaths from CVDs, with the overall average annual ASR of 148.4 per 100 000. The trend of ASRs from CVDs mortality in males in Serbia showed a significant joinpoint: rates insignificantly decreased from 1997 to 2005 by '0.8% per year (95% CI '1.7% to 0.2%) and thereafter rapidly decreased by '5.0% per year (95% CI '5.6% to '4.5%). A joinpoint for females was found in 2006: the mortality trend was first significantly decreasing by '1.0% per year (95% CI '1.9% to '0.0%) and then sharply falling down by '6.0% per year (95% CI '6.8% to '5.3%). Results of age-period-cohort analysis indicated that the relative risk for CVDs mortality showed statistically significant (p<0.05) cohort and period effects, as well as the net drift and local drifts in Serbian population. The trends in mortality for all subtypes of CVDs were similar in both sexes: trends significantly decreased for most subtypes, with the exception of a significant increase for cerebral infarction. Conclusions After a decade of increase, CVDs mortality rates are declining in last decade in Serbia. However, mortality rates from CVDs remain exceedingly high in Serbia. Differences in mortality trends of the stroke subtypes should be taken into account in the creation of both prevention and treatment guidelines

Outbreak of early syphilis in an institution for the care of adults with mental disorders

This paper describes the features of an outbreak of early syphilis in an institution for the care of adults with mental disorders. A case-note review was performed. In the period June to November 2001, 87 cases of syphilis were diagnosed [25 primary, 21 secondary and 41 early latent syphilis in 983 inmates (crude attack rate 8·9%)]. Among them 82 were heterosexual, four were homosexual or bisexual, and for one case sexual preference was not established. About half the cases were known to be promiscuous. The initial case was not identified. Penicillin therapy was administered to all cases and all known or suspected sexual contacts. Sporadic cases of syphilis have, however, continued to emerge from time to time. Institutions for patients with mental disorders are vulnerable to sexually transmitted diseases, and special strategies should be devised for their control

Psychometric properties of the world health organization’s quality of life (WHOQOL-BREF) questionnaire in medical students

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Background and Objectives: Studies on the effects of studying on a medical student’s quality of life are sparse. The World Health Organization Quality of Life (WHOQOL-BREF) questionnaire is a widely used scale that enables the assessment and international comparisons of the quality of life. The aim of this study was to evaluate psychometric properties of the WHOQOL-BREF questionnaire among Serbian medical students. Material and Methods: We conducted a crosssectional study that involved 760 medical students at a state medical faculty at the University of Kragujevac, Serbia. The reliability of the WHOQOL-BREF was evaluated using Cronbach’s alpha coefficient and test–retest analysis, and the validity was examined using principal component analysis, with Promax rotation method. Results: Cronbach’s alpha coefficient for the whole WHOQOL-BREF scale was 0.896. Internal reliability for all domains was above 0.70, except for the domain “Social Relationships” (0.533). The test–retest reliability for all domains was significant at p < 0.01 level, showing good stability of the scale. Principal component analysis with Promax rotation method indicated four main components that explained 49.5% of variance. Conclusion: The Serbian version of the WHOQOL-BREF scale showed satisfactory psychometric properties that facilitate estimation of the quality of life of medical students

Risk Factors for Anaplastic Thyroid Cancer

Background. Anaplastic thyroid cancer (ATC) is a form of thyroid cancer with very poor prognosis, but is fortunately quite rare. Its aetiology is unknown and not well researched. Aim. The aim of this study was to identify potential risk factors for ATC. Material and Method. Case-control study of 126 ATC patients (77 females and 49 males) and 252 controls individually matched by gender, age, and place of abode. In statistical analysis we used a Cox regression model. Results. Univariate logistic regression showed that the risk factors for ATC are low education level, type B blood group, goitre, other nonthyroid malignancies, diabetes, late menarche, and an early first pregnancy. Multivariate logistic regression analysis showed that independent risk factors for ATC are low education level (OR = 1.42, 95% CI = 1.09-1.86), type B blood group (OR = 2.41, 95% CI = 1.03-5.66), and goitre (OR = 25-33, 95% CI = 5.66-126.65). Conclusion. Independent risk factors for ATC are: low education level, type B blood group, and goitre

Comparison of lung diffusing capacity in young elite athletes and their counterparts

Background: The influence of exercise on the pulmonary function is controverse, some studies have reported no sports influence, while the others have found positive correlation. Aim: To evaluate and compare the sports influence on pulmonary function: spirometry (VC, FVC, FEV1, FEV1/FVC), lung diffusing capacity (DLCO) and coefficient of the CO gas transfer (KCO) in two elite athletes groups and healthy sedentary controls. Method: Equally divided into aerobic and anaerobic group, 60 elite athletes were recruited, as well as 43 age-matched, healthy sedentary controls. All of the participants performed basic anthropometric measurements, spirometry, DLCO and KCO at rest. Kruskal–Wallis one way ANOVA test was used to determine differences between groups; Mann–Whitney U test was used for inter-groups differences and Pearson coefficient for pulmonary variables and anthropometric parameters correlation. Statistical analyses were performed using the SPSS computer statistic program, version 20. Results: No differences were found in pulmonary characteristics (spirometric function values, DLCO and KCO) in athletes and non-athletes at rest, as well as between aerobics and anaerobics. There were no correlations between the anthropometric parameters and the investigated respiratory function tests. DLCO (%) correlated positively with height in athletes playing anaerobic type of sport (karate and taekwondo) (p = 0.036; r = 0.544), and negatively in sedentary control group (p = 0.030; r = −0.560). Regarding KCO, no differences were found. Conclusion: Spirometry indices and DLCO are not influenced either by aerobic or anaerobic training type, so benefits of sports on pulmonary indices or DLCO was not confirmed. Keywords: Athletes, Diffusing capacity, Transfer coefficien

Breast-Feeding and Childhood-Onset Type 1 Diabetes:A pooled analysis of individual participant data from 43 observational studies

OBJECTIVE To investigate if there is a reduced risk of type 1 diabetes in children breastfed or exclusively breastfed by performing a pooled analysis with adjustment for recognized confounders. RESEARCH DESIGN AND METHODS Relevant studies were identified from literature searches using MEDLINE, Web of Science, and EMBASE. Authors of relevant studies were asked to provide individual participant data or conduct prespecified analyses. Meta-analysis techniques were used to combine odds ratios (ORs) and investigate heterogeneity between studies. RESULTS Data were available from 43 studies including 9,874 patients with type 1 diabetes. Overall, there was a reduction in the risk of diabetes after exclusive breast-feeding for >2 weeks (20 studies; OR = 0.75, 95% CI 0.64-0.88), the association after exclusive breast-feeding for >3 months was weaker (30 studies; OR = 0.87, 95% CI 0.75-1.00), and no association was observed after (nonexclusive) breast-feeding for >2 weeks (28 studies; OR = 0.93, 95% CI 0.81-1.07) or >3 months (29 studies; OR = 0.88, 95% CI 0.78-1.00). These associations were all subject to marked heterogeneity (I(2) = 58, 76, 54, and 68%, respectively). In studies with lower risk of bias, the reduced risk after exclusive breast-feeding for >2 weeks remained (12 studies; OR = 0.86, 95% CI 0.75-0.99), and heterogeneity was reduced (I(2) = 0%). Adjustments for potential confounders altered these estimates very little. CONCLUSION The pooled analysis suggests weak protective associations between exclusive breast-feeding and type 1 diabetes risk. However, these findings are difficult to interpret because of the marked variation in effect and possible biases (particularly recall bias) inherent in the included studies