Natasa Maksimovic

Health-related quality of life in patients with atopic dermatitis.

Atopic dermatitis (AD) is a chronic relapsing condition that can have considerable effects on the patients’ quality of life (QOL). The aim of this study was to measure the health‐related QOL in patients with AD, using generic and specific instruments, to compare the scores obtained by different instruments and to verify the relationship between them. We conducted a cross‐sectional study of 132 outpatients with AD. To assess the QOL, Short Form 36 (SF‐36), Dermatology Life Quality Index (DLQI) and Children’s Dermatology Life Quality Index (CDLQI) were administered. In order to assess the disease severity of AD, we used the Eczema Area and Severity Index (EASI) and physician assessment of disease severity. Stressful life events during the last 12 months were assessed with Paykel’s Interview for Recent Life Events. Patients with AD had inferior social functioning and mental health scores compared with the general population. The correlations between the DLQI and SF‐36 were found for the mental components of the QOL. Increasing disease severity was associated with greater impairment in QOL in both, children and adults. Our study found the influence of the stressful life events on the role emotional of AD patients. These results demonstrate that AD influences health‐related QOL, especially in children. This study supports the decision to use both generic and skin‐specific instruments to assess the impact of AD on QOL.

Risk factors for psoriasis: A case–control study

A case–control study of 110 consecutive psoriatic outpatients and 200 unmatched controls was carried out in order to analyze the association of psoriasis with smoking habits, alcohol consumption, family history of psoriasis and stressful life events. Stressful life events were assessed with Paykels Interview for Recent Life Events, a semi‐structured interview covering 63 life events. According to our results, the risk of psoriasis is higher in urban dwellers (odds ratio [OR] = 3.61; 95% confidence interval [CI] = 0.99–13.18), patients who were divorced (OR = 5.69; 95% CI = 2.26–14.34) and those exposed to environmental tobacco smoke at home (OR = 2.29; 95% CI = 1.12–4.67). Alcohol consumption (OR = 2.55; 95% CI = 1.26–5.17), family history of psoriasis (OR = 33.96; 95% CI = 14.14–81.57) and change in work conditions (OR = 8.34; 95% CI = 1.86–37.43) are also risk factors for psoriasis. Separate analyses for men and women showed that the risk of developing psoriasis was stronger in men with a family history of psoriasis (OR = 30.39; 95% CI = 6.72–137.42) than in women (OR = 16.99; 95% CI = 7.21–40.07). The effect of environmental tobacco smoke at home was found only in women (OR = 2.44; 95% CI = 1.26–4.73). Future well‐designed epidemiological studies need to be performed in order to determine whether lifestyle factors and stress could be risk factors triggering or aggravating psoriasis.

Occupational Exposure to Blood and Body Fluids among Health-Care Workers in Serbia

Objectives: The aim of this study was to examine the epidemiology of occupational accidents and self-reported attitude of health-care workers (HCWs) in Serbia. Subjects and Methods: A cross-sectional study was conducted among HCWs in selected departments of five tertiary care hospitals and in one secondary care hospital in February 2012. A previously developed self-administered questionnaire was provided to HCWs who had direct daily contact with patients. χ2 test and Students t test were used for statistical analysis of the data. Results: Of the 1,441 potential participants, 983 (68.2%) completed the questionnaire: 655 (66.7%) were nurses/medical technicians, 243 (24.7%) were physicians and 85 (8.6%) were other personnel. Of the 983 participants, 291 (29.6%) HCWs had had at least one accident during the previous year and 106 (40.2%) of them reported it to the responsible person. The highest prevalence (68.6%) of accidents was among nurses/technicians (p = 0.001). Accidents occurred more often in large clinical centers (81.1%; p < 0.001) and in the clinical ward, intensive care unit and operating theater (p = 0.003) than in other departments. Seventy-six (13.1%) nurses/medical technicians had an accident during needle recapping (p < 0.001). Of all the HCWs, 550 (55.9%) were fully vaccinated, including significantly more doctors (154, 63.4%) than participants from other job categories (p < 0.001). Conclusion: There was a relatively high rate of accidents among HCWs in our hospitals, most commonly amongst nurses and staff working in clinical wards, intensive care units and operating theaters. The most common types of accidents were needlestick injuries and accidents due to improper handling of contaminated sharp devices or occuring while cleaning instruments or by coming into contact with blood through damaged skin or through the conjunctiva/mucous membranes.

Quality of life in patients with alopecia areata: a hospital‐based cross‐sectional study

Previous studies suggest that alopecia areata (AA) may significantly affect patient quality of life (QoL). There are no studies that assess QoL in Serbian AA patients.

Prevalence and quality of life in high school pupils with acne in Serbia

BACKGROUND/AIM Acne is a common problem in adolescent children with considerable emotional and psychological effects. The aim of this study was to determine the self-reported prevalence of acne and to assess its impact on the quality of life in high school pupils in Serbia. METHODS The cross-sectional study was conducted in May 2011 in two medical high schools in Serbia. Only pupils who gave a written informed consent to participate in the study (n = 440) were asked to fill in two questionnaires: short demographic questionnaire and Cardiff Acne Disability Index (CADI), a disease-specific questionnaire measuring disability induced by acne. Internal consistency (tested by Cronbachs alpha) and item-total score correlations (Spearmans correlation analysis) were used for reliability analyses. RESULTS The study population consisted of 440 pupils, 281 from Belgrade and 159 from Uzice. Among them 371 (84.3%) were girls and 69 (15.7%) boys, with similar sex distribution in Belgrade and Uzice. The total mean age of pupils was 16.48 years (SD = 0.55). Out of 440 pupils 228 (51.8%) self-reported their acne. The acne prevalence was significantly higher in pupils from Uzice (73.6%) than in those from Belgrade (39.6%). The overall mean CADI score for the whole sample was 2.87 +/- 2.74, with the similar quality of life impairment in adolescents from Belgrade and from Uzice. The mean Cronbachs alpha was 0.82. CONCLUSION This study shows that the quality of life impairment due to acne is mild for the majority of the affected pupils. The Serbian version of the CADI is a reliable, valid, and valuable tool for assessing the impact of acne on the quality of life.

Risk factors for basal cell carcinoma: Results from the case-control study

The aim of the present case-control study was to assess the risk factors for Basal cell carcinoma (BCC) in the Montenegrin population. The study group was comprised of 100 consecutive patients with a diagnosis of BCC, while the control group consisted of patients who did not present skin cancer and who were individually matched to the cases by sex and age. The increased risk for BCC was associated with: the presence of nevi (odds ratio [OR] = 3.77; 95% confidence interval [CI] = 1.12–12.73), type of skin concerning to burn rather than to tan after repeated sun exposure in childhood or adolescence (OR = 3.14; 95% CI = 1.59–6.18), the skin reaction to burn after two or more hours of sunlight during childhood or adolescence (OR = 4.53; 95% CI = 2.37–8.63), the number of severe and painful sunburns during their lifetime(OR = 3.52; 95% CI = 1.68–7.38), outdoor work during the summer-time (OR = 2.73; 95% CI = 1.00–7.45), occupational exposure to chemicals (OR = 17.89; 95% CI = 2.82–113.52), history of eczema (OR = 4.17; 95% CI = 1.53–11.39), and history of previous BCC (OR = 3.86; 95% CI = 1.40–10.65). Our study confirms the role of environmental and constitutional factors in development of BCC.

Risk factors for the development of hospital infections in the intensive care units

BACKGROUND Patients admitted to intensive-care units (ICU) are at a high risk of nosocomial infections (NI) due to susceptibility associated with severity of their condition, but also the invasive medical procedures they undergo. AIM To determine the frequency of NI at the ICU of the General Hospital Uzice, and to identify the risk factors for their development. METHODS A prospective surveillance study of NI, conducted between June 27. and December 31 2001, included 914 patients who spent at least 24 hours in the ICU (total of 2 615 days). The surveillance of NI in the ICU was carried out daily. Follow-up period covered the time from the ICU admission to 48 hours after the ICU discharge. To assess risk factors for NI, we performed a case-control study. The variables measuring of extrinsic and intrinsic risk factors for NI were collected. RESULTS In a six-month prospective surveillance study, the incidence of NI was 16.7% or 58.5 per 1,000 patient-day, respectively. The most frequent were the infections of the surgery wounds (32.6%), urinary tract infections (23.5%), and infections of the blood (7.1%). The identified independent risk factors for NI were: surgical intervention (OR = 5.74; CI = 2.01-16.41), endotracheal tubes (OR = 3.40; CI = 1.07-10.89), cystoscopy (OR = 2.35; CI = 1.38-4.02), obesity (OR = 1.98; CI = 1.27-3.11), and the duration of the infusion (OR = 1.34; CI = 1.23-1.46). CONCLUSIONS The most important risk factors for NI at ICU were surgical interventions and endotracheal tubes.

Serbian medical students’ fertility awareness and attitudes towards future parenthood

Abstract Objectives: Medical students represent a group particularly at risk of involuntary childlessness due to their highly demanding careers and university curriculum. The aim of this study was to investigate Serbian medical students’ attitudes towards future parenthood and their awareness of fertility issues. Methods: A cross-sectional study was conducted among fourth year students at the Faculty of Medicine, University of Belgrade, Serbia, between 12 and 16 December 2016. Data were collected through an anonymous 56-item validated questionnaire, translated into the Serbian language. The participation rate was 87.1%. Results: More than 95% of students, regardless of gender, wanted to have children in the future; most indicated three as the desired number of children. Both genders equally rated the importance of having children. Women rated significantly higher the likelihood of IVF treatment or child adoption if faced with infertility (both p = .001). All students wanted to have their first child before the age of 35 years. Knowledge about the age-related decline in female fertility was not satisfactory. Women found it more important to have children when they felt sufficiently mature, were in a stable relationship, were financially secure, had completed their studies, were not too old to have children, and had access to childcare, although these prerequisites were rated highly by both genders. Conclusion: Serbian medical students greatly value and have a positive perception of future parenthood. Appropriate education is needed, however, because of their inadequate knowledge of the age-related decline in female fertility.

Incidence and Mortality Patterns of Acute Myeloid Leukemia in Belgrade, Serbia (1999–2013)

Introduction: To assess incidence and mortality trends of acute myeloid leukemia (AML) in Belgrade (Serbia) in a 15-year period (from 1999 to 2013). Material and Methods: Data were obtained from the Cancer Registry of Serbia, Institute of Public Health of Serbia. Standardized incidence and mortality rates per 100,000 inhabitants were calculated by direct standardization method using World Standard Population. Analysis of raw data indicated single-digit numbers per year and per 5-year age cohorts. Therefore, we merged years of diagnosis to three-year intervals, creating so-called “moving averages”. We also merged study population to 10-year age cohorts. Results: Both incidence and mortality rates increased with age, i.e., the lowest rates were observed in the youngest age groups and the highest rates were observed in oldest age groups. In all age groups, except the youngest (15–24 years), AML incidence was statistically significantly higher in men compared with women. Average age-adjusted incidence was 2.73/100,000 (95% confidence interval (CI) 2.28–3.71). Average age-adjusted mortality was 1.81/100,000 (95% CI 1.30–2.26). Overall, there were no significant changes in incidence trend. Age-adjusted incidence rates had increasing tendency among men aged 65–74 years (B = 0.80, standard error (SE) = 0.11; p = 0.005) and in total population aged 65–74 years (B = 0.41, SE = 0.09; p = 0.023). Increasing tendency in incidence of AML among women was observed in age group >75 years (B = 0.63, SE = 0.14; p = 0.019). No changes of mortality trend were observed. Conclusion: There was no significant change in trends of AML from 1999 to 2013 in the population of Belgrade.

Psychosomatic factors of atopic dermatitis exacerbation

The aim of this study was to estimate whether the stress, lack of social support, and poor emotional relationships influence the recurrence of AD in adults.