Biljana Kocić

Health-related quality of life in patients after the acute myocardial infarction

IntroductionAcute myocardial infarction has a negative impact on patient’s quality of life. The aim of this paper was to evaluate the health-related quality of life in patients one month after the acute myocardial infarction.Material and methodThe study involved 160 patients of both sexes, 30 to 79 years of age. The health-related quality of life in patients was assessed at the admission at the coronary care unit, and one month after. The following questionnaires were used: EuroQuolVAS and EuroQuol 5 Dimension. Angina pectoris was ranked according to the Canadian Cardiovascular Society Classification. Results: Men and women evaluated their health condition in a similar way (60.48±11.98 vs 60.55±12.24). Patients who (have) undergone primary coronary intervention had significantly higher average scores on EuroQuolVAS than the patients who were treated with thrombolytic therapy (68.69±9.67 vs 52.31±7.87, p<0.001). Modest and severe problems were the most presented in answers to those questions: pain/discomfort, anxiety/depression and self-care. Both men (0.92±0.43 vs 3.27±0.59, p<0.001) and women (0.89±0.46 vs 3.19±0.55, p<0.001) had significiantly lower average marks of angina pectoris one month after the acute myocardial infarction than at the admission to the hospital.ConclusionOne month after the acute myocardial infarction the quality of life in patients was very impared. Patients who undergone to the primary coronary intervention evaluated their health condition as better than the patients who were treated with thrombolytic therapy. Those patients also had the lower average marks of angina pectoris and the higher health-related quality of life.

THE INFLUENCE OF MARITAL STATUS ON EPIDEMIOLOGICAL CHARACTERISTICS OF SUICIDES IN THE SOUTHEASTERN PART OF SERBIA

BACKGROUND The support of close persons is a protective factor in the suicide epidemiology. The aim of this paper is to determine if there are differences between epidemiological characteristics of the suicides committed by married people in relation to singles. METHODS In order to determine epidemiological characteristics of suicide among married and single people in the southeastern Serbia 628 suicides committed from 1995 to 2002 among persons 20 years of age and over were analysed. To compare suicide rates between married and single persons chi2 test was performed. RESULTS From 628 registered suicides, 188 were performed by women, and 440 by men. The average annual suicide rate among males was 24.1 per 100,000 and among females it was 9.9. The highest rates were among widowed (139.0) and divorced men (63.2). The highest risk factor for suicide was to be widowed (men: RR=8.35; women: RR=2.75). The suicide trend among women, both married and single has been declining, whilst among males it has been on significant increase. Seasonality of suicides, weekly and daily distribution had a small influence on the epidemiological characteristics of suicides. Married women committed more suicides by poisoning than single women (p=0.02). In both groups, the most frequent way is hanging. CONCLUSION Though marital status plays important role in an increasing rates of suicide, time and the way of its happening, this role is not decisive. Single people are very vulnerable and the time and way of suicide show that their reasons are more serious than among married ones.

Trends in incidence of non-melanoma and melanoma skin cancers in central Serbia

Online first: January 30, 2018 SUMMARY Introduction/Objective The incidence of both melanoma and non-melanoma skin cancers (NMSC) has been increasing over the past decades worldwide. NMSC is the most common cancer in white population and melanoma is one of the deadliest cancers today. The objective of the paper was to determine trends in age-standardized incidence rates of NMSC and melanoma in central Serbia from 1999 to 2013. Method A descriptive epidemiological study was done. Data about incidence for NMSC and melanoma were obtained from the Serbian Cancer Registry and data about population originating from 1991, 2001, and 2011 censuses. Crude incidence rates were calculated per 100,000 inhabitants. Direct method of standardization was performed with the world population as the standard. Trend lines were estimated using linear regression. Results During a 15-year period, the total number of new NMSC cases was 41,719 [21,690 (52%) in men and 20,029 (48%) in women]. There were 5,781 new cases of melanoma [2,969 (51.4%) in men and 2,812 (48.6%) in women]. A significantly increasing incidence trend for NMSC both in men (y = 0.617x + 24.29, R2 = 0.500) and women (y = 0.672x + 0.670, R2 = 0.670) was determined. In the same period, a statistically significant increase of incidence trend for melanoma was determined in men (y = 0.111x + 3.708, R2 = 0.384) and in women (y = 0.098x + 3.375, R2 = 0.409). NMSC was registered in persons of all ages. NMSC incidence increased rapidly in persons older than 50 years. Melanoma predominates in children and adolescents and is registered more frequently than NMSC in persons bellow 60 years of age. Conclusion Our findings showed significantly increasing trend of age-standardized incidence rates for both NMCC and melanoma. In the observed period, there were 7.2 times more new cases of NMSC than melanoma in the population of central Serbia. There were more registered new cases of NMSC and melanoma in men than in women. Screening of skin cancers and earlier diagnosis may improve treatment and prognosis.

Identifying elderly persons who are at risk of falling and fall risk factors in the general population

Introduction/Objective The aim of this study was to identify the elderly who are at increased risk of falling, as well as the risk factors for falls in the general population. Methods This cross sectional study included a random sample of 400 people (164 men and 236 women) with the average age of 75.04 (65–94) years selected from the Register of the Primary Health Center in Niš, Serbia. Socio-demographic questionnaire, the Elderly Fall Screening Test, and the Multi-factor Falls Questionnaire were used. Odds ratio (OR) was evaluated and adjusted for gender, age, marital status, education level, and self-assessment of the health state. Results The risk of falling and risk factors for falls were as follows: age [odds ratio (OR) = 1.129, confidence interval (CI) = 1.067–1.196], health self-assessed as good (OR = 0.365; CI = 0.142–0.938), limitation of activities (OR = 7.189; CI = 3.559–14.522), walking problems (OR = 2.153; CI = 1.046–4.428), osteoporosis (OR = 4.611; CI = 1.231–17.265), female gender (OR = 3.770, CI = 1.648–8.624), vision problems (OR = 2.719; CI = 1.588–108.581), cognitive problems (OR = 4.485; CI = 17.721), arthritis (OR = 6.524; CI = 2.077–20.496), and urination problems (OR = 2.511; CI = 1.083–5.820). Conclusion Risk factors for falls were the following: age, self-assessment of health state, walking problems, osteoporosis, female gender, vision problems, arthritis, and urination problems.

Epidemiological Characteristics of Carrying Viral Hepatitis B Antigen in the Population of the Nišava District

Summary The aim of this paper was to determine the trend of diseases and epidemiological characteristics of viral antigen carrying of hepatitis B for better implementation of prevention and control of the disease activity. The annual reports, reports of diseases - deaths from infectious diseases, epidemiological survey of the Public Health Institute (IPH) Niš were used as the material. The period from 2002 to 2011 in the Nišava District was considered. A descriptive method was used. HBsAg carrying shows an upward trend (y=15+3.27 x). Most carriers are males (57.27%), live in urban areas (98.16/ 100.000 population), average age 41.92 years old ±SD 18.59, pensioners (22.42%). 54.05% are nephrology patients (almost all retirees under the age of 60 years old). Only 15.76% were hospitalized. The data on the vaccination status are insufficient. In 5.45%, co-infection with hepatitis C virus was found. 63.33% belong to the group of patients for whom there were no data on the mode of transmission. Hemodialysis patients make 16.67%, blood donors 9.39%, 6.36% pregnant women and injecting drug users 1.21%. The upward trend of carrying, the presence of all known risk groups in the population of carrying in the Nišava District points to the need for improved epidemiological surveillance, strict application of protective measures, conducting of statutory vaccination of all categories of people exposed to particular risk of infection as well as continuing education on preventive measures of both population and health care providers.

Epidemiological characteristics of carriers of antibody against hepatitis C virus in the population of Nišava district

SUMMARY The aim of the paper was to determine the disease trends and characteristics of anti-HCV antibody carrier status for the purpose of better prevention and disease control. The materials used were annual reports, reports of diseases and deaths from infectious diseases, and epidemiological surveys of the Public Health Institute Niš in the period from 2002 to 2011 in the Nišava District. A descriptive epidemiological method was used. Rates were non-standardized and were calculated per 100.000 residents. There was an upward trend (y=-5.4+8.21 x±R²=0.53) of HCV carriers. Most carriers were male (68.34%), from urban areas (81.66%), aged 37.75±SD 16.80 years on the average, and unemployed (39.45%) (out of which the inmates of the Correctional Facility in Niš making up 26.11%). More than half of the registered carriers (59.05%) were not able to report the precise mode of transmission. Then followed hemodialysis patients (15.83%), injecting drug users (11.06%), blood donors (4.77%), pregnant women (3.52%), mother-to-child transmission cases (2.26%), and health professionals (0.75%). There were 14.82% of hospitalized cases. In 4.52%, a coinfection with hepatitis B virus was found. HCV carrier status in the Nišava District showed an upward trend. Low incidence rates might have been the result of underreporting. Since there is no anti-HCV vaccine, it is necessary to focus on the activities of health education of all categories of people at risk, as well as on the service providers in different sectors, risk factors, modes of transmission and protection measures. Sažetak Cilj rada bio je utvrđivanje trenda oboljevanja i karakteristike nosilaštva antitela na virusni hepatitis C radi boljeg sprovođenja prevencije i suzbijanja ove bolesti. Kao materijal korišćeni su godišnji izveštaji, prijave zaraznih bolesti, epidemiološke ankete Instituta za javno zdravlje Niš za period 2002-2011. godine na području Nišavskog okruga. Korišćen je deskriptivni metod rada. Stope su nestandardizovane i izračunavane su na 100000 stanovnika. Nosilaštvo HCV antitela pokazuje uzlazni trend (y=-5,4+8.21x±R²=0.53). Većinu nosilaca čine osobe muškog pola (68.34%), iz gradske sredine (81.66%), prosečne starosti 37.75 godina ±SD 16.80, nezaposleni (39.45%). Među nezaposlenima, štićenici Kazneno-popravnog zavoda čine 26.11%. Više od polovine registrovanih nosilaca (59.05%) nema utvrđen način transmisije; slede bolesnici na hemodijalizi (15.83%), intravenski korisnici droga (11.06%), dobrovoljni davaoci krvi (4.77%), trudnice (3.52%), transmisija sa majke na dete (2.26%) i zdravstveni radnici (0.75%). Hospitalizovano je 14.82%. Kod 4.52% nađena je koinfekcija sa hepatitis B virusom. Nosilaštvo HCV antitela u Nišavskom okrugu pokazuje uzlazni trend. Niske stope incidencije mogu da budu posledica podregistracije. Pošto protiv HCV infekcije ne postoji vakcina, potrebno je pojačati aktivnosti na edukaciji svih kategorija lica u riziku, kao i pružalaca usluga u različitim sektorima, o faktorima rizika, načinima transmisije i merama zaštite.

Cervical Cancer Trends in the Toplica District

SUMMARY Cervical cancer is the third most common malignant neoplasm in women. It is also the fourth cause of death in women amongst malignant neoplasms in the Toplica District. The aim of the paper was to show the most important epidemiological characteristics of cervical cancer and to analyze its incidence and mortality trends during the period 1999-2012. Data on cancer for Toplica District were obtained in the Public Health Institute Niš. Descriptive epidemiological method was used. Crude rates were calculated per 100.000 inhabitants (Census 2002). During the study period, there were 230 newly diagnosed women, out of which 84 died due to cervical cancer. The average age of women who were diagnosed with cancer was 58.9 years. The average age of deceased women was 60.6 years. The average annual crude incidence rate was 32.12 and mortality rate was 11.74. Cervical cancer incidence rates decreased while mortality rates showed a slight increase. The highest incidence rate was in the municipality of Prokuplje (25.45) and the highest mortality rate was in the municipality of Kuršumlija ( 8.11). The lowest incidence rate was in the municipality of Blace (16.15) and the lowest mortality rate in the municipality of Žitorađa (6.01). Cervical cancer is an important sociomedical problem amongst women during their reproductive period. Efficient implementation of primary and secondary preventive measures may lead to a reduction in the incidence and mortality rates due to this cancer.