Sandra Sipetic

Prevalence of menstrually related migraine and nonmigraine primary headache in female students of Belgrade University.

Objectives.—To determine prevalence and characteristics of menstrually related migraine and nonmigraine headache in female students of Belgrade University.

Environmental Factors and Parkinson's Disease: A Case-Control Study in Belgrade, Serbia

ABSTRACT A case-control study was performed in Belgrade in order to investigate the association between Parkinsons disease (PD) and some environmental factors. During the period 2001–2005, 110 new PD cases and 220 hospital controls were interviewed. Cases and controls were matched by sex, age (±2 years), and place of residence (urban/rural). According to multivariate conditional logistic regression analysis, PD was positively asssociated with exposure to insecticides (odds ratio (OR) 3.22, 95% confidence interval (95% CI) 1.32–7.87), dyes (OR 25.33; 95% CI, 2.89–222.0), and naphtha and its derivates (OR 9.53; 95% CI, 1.04–86.96), and with gardening (OR 5.51; 95% CI, 3.04–10.01), well water drinking (OR 2.62; 95% CI, 1.40–4.90), and spring water drinking (OR 2.19; 95% CI, 1.15–4.16). Negative association was found for service-sector working (OR 0.15; 95% CI, 0.04–0.59). The results obtained did not changed after adjustment for smoking. The findings of the present study support the role of environmental factors in the occurence of PD.

A survey of female students with migraine: what is the influence of family history and lifestyle?

Objectives: To compare characteristics of migraine and some lifestyle habits in migraineurs with and without a positive family history for migraine. Method: The prevalence study was combined with a case-control study and comprised 245 female students with migraine. Results: Out of 245 female students with migraine, 132 (53.9%) had a positive family history for migraine. In comparison with migraineurs who had not, those with a positive family history were younger at the onset of migraine and significantly more frequently reported menstrual migraine (p < 0.001), unilateral pain (u2009p < 0.05) and pulsate pain (u2009p < 0.05) as well as severe headache (u2009p < 0.01). In comparison to migraineurs with a positive family history for migraine, those who did not report a significantly higher frequency of average number of meals per day of <3 (u2009p < 0.001), missed meals (u2009p < 0.05) and an average sleep duration of ≤6 h (u2009p < 0.05). Conclusions: The results of the present study are in line with literature showing a high frequency of positive family history for migraine among migraineurs. They also suggest that subjects with a positive family history have a lower “migrainous threshold” for the development of migraine and that environmental factors are more important for the occurrence of migraine in subjects without a positive family history. Accordingly, the conclusions of this study are limited to reproductive aged women.

Improvement of quality of life in patients with benign goiter after surgical treatment.

PurposeA quality of life (QoL) assessment is considered an important outcome measure in the treatment of benign thyroid diseases. The aims of this study were to analyze the impact of different surgical treatments on QoL in patients with benign thyroid diseases and to evaluate factors correlating with the QoL outcomes.MethodsA prospective longitudinal study was conducted. One hundred thirty-two patients met the inclusion/exclusion criteria and completed the disease-specific questionnaire, thyroid patient-reported outcome (ThyPRO), before surgery and after 6xa0months. Preoperative and postoperative QoL outcomes were compared and correlating factors were analyzed.ResultsIndication for surgery was euthyroid goiter, toxic goiter, and suspicious malignant thyroid disease in 58.3, 29.5, and 12.1xa0% of the patients, respectively. None of the patients had overtly toxic goiter. There were 65.2xa0% of the patients who underwent total thyroidectomy, while 34.8xa0% underwent hemithyroidectomy. The total postoperative complication rate was 5.3xa0%. QoL improved significantly after surgical treatment, independent of the extent of performed surgery. The most affected domain, pre- and postoperative, was for tiredness. QoL improvement was significant for women in all domains, while for men, it was significant in only three domains (goiter symptoms, emotional susceptibility, and cosmetic complaints) and in overall QoL. Younger patients had significantly better cognitive functioning and daily life, while elderly patients had significantly less cosmetic complaints. The factors that significantly correlated with improvement of QoL in different domains were lower education level, duration of disease, and microcarcinoma at final histology.ConclusionQoL in patients with benign thyroid diseases improves significantly after operative treatment, independent of the extent of the operation.

Risk factors for well-differentiated thyroid cancer in men

AIMS AND BACKGROUNDnThyroid cancers are relatively rare tumors that appear more frequently in women than in men. Accordingly, most studies focus on studying risk factors for thyroid cancer in women and consequently on various hormonal or reproductive factors that are specific for women. The aim of our study was to examine risk factors for developing well-differentiated thyroid cancer in men. Heretofore, we did not encounter in the literature a study that was solely focused on studying risk factors for well-differentiated thyroid cancer in men.nnnMETHODSnA case-control study was performed from 2005 to 2010. The case group included 204 consecutive well-differentiated thyroid cancers in male patients (180 papillary and 24 follicular including Hürthle cell). The control group comprised the same number of cases. Patients were individually matched by gender, age and place of residence. Statistical analysis included conditional univariate and multivariate logistic regression methods.nnnRESULTSnAccording to univariate logistic regression, well-differentiated thyroid cancer in men was significantly related to smoking status, duration of smoking, number of cigarettes smoked per day, history of goiter or thyroid nodules, history of non-thyroid cancer, diabetes mellitus, radiotherapy of the head and neck, and history of malignant tumors. According to multivariate logistic regression, it was independently related to smoking status (OR = 0.36; 95% CI, 0.19-0.69), history of goiter or thyroid nodules (OR = 9.19; 95% CI, 1.25-64.58), and a history of malignant tumors (OR = 2.11; 95% CI, 1.19-7.33).nnnCONCLUSIONSnRisk factors for well-differentiated thyroid cancer in men were goiter or thyroid nodules and family history of malignant tumors. Cigarette smoking was negatively associated with the disease.

Rising incidence of Type 1 diabetes in Belgrade children aged 0–14 years in the period from 1982 to 2005

Background: Type 1 diabetes (T1DM) is an autoimmune disease in which both genetic and environmental factors play a role in the etiology. Aim: The aim of this study was to analyze the incidence of T1DM. Methods: A retrospective technique was used to register all newly diagnosed cases of T1 DM in Belgrade (Serbia) children at the age of 0–14 yr between 1982 and 2005. The incidence was adjusted directly by age using the Segi’s world population as the standard. A total of 702 cases was identified from the two sources: patients’ records from two pediatric hospitals in Belgrade referent for the disease, and from the population based register. Results: The average annual age adjusted incidence rate of T1DM for Belgrade was 10.4/100, 000 [95% confidence interval (95% CI)=3.8–15.4]. It was slightly higher in boys than in girls. The age-specific annual incidence rates (per 100, 000) for the age groups 0–4, 5–9, and 10–14 were 5.5 (95% CI=4.5–6.7), 11.9 (95% CI=10.5–13.5), and 15.4 (95% CI=13.8–17.1), respectively. Over the 24 yr incidence rates significantly increased by 8.5% for boys and 3.0% for girls. The highest increase of incidence rate was in the 5–9 age group. Discussion: The results obtained are in line with data from other studies showing that the incidence of T1DM has been increasing in almost all populations worldwide.

Improved quality of life in hyperthyroidism patients after surgery.

BACKGROUNDnThe most common causes of hyperthyroidism are Graves disease (GD) and toxic nodular goiter (TNG). GD and TNG might influence patients quality of life (QoL). The aim of our study was to analyze and compare the QoL of patients with GD with that of TNG patients and to evaluate the influence of surgical treatment on their QoL.nnnMATERIALS AND METHODSnA prospective case-control study was conducted at the Center for Endocrine surgery in Belgrade, Serbia. The ThyPRO questionnaire was used in the QoL assessment of the GD and TNG patients (31 and 28, respectively) pre- and post-operatively.nnnRESULTSnAll patients were receiving antithyroid drugs, and none of the patients were overtly hyperthyroid at the time of completing the preoperative questionnaire. The QoL of the GD patients was worse than that of the TNG patients, with significant differences in eye symptoms, anxiety, and sex life domains (P < 0.001, P = 0.005, and P = 0.004, respectively), preoperatively, and in eye symptoms, anxiety, emotional susceptibility, and overall QoL (P = 0.001, P = 0.027, P = 0.005 and P = 0.013, respectively), postoperatively. The improvement in QoL in the GD patients was significant after surgical treatment in all ThyPRO domains. In the TNG patients, the improvement was significant in all but one ThyPRO domain, sex life (P = 0.066).nnnCONCLUSIONSnThe QoL of GD patients is worse than those of TNG patients. Surgery may improve QoL in patients with GD and TNG even if they have achieved satisfying thyroid status with medication treatment, preoperatively.

Quality of life improvement in patients with Hashimoto thyroiditis and other goiters after surgery: A prospective cohort study

INTRODUCTIONnHashimoto thyroiditis (HT) and other benign goiters (BG) might influence patients quality of life (QoL). The objective of this study was to analyze influence of surgery on these patients QoL.nnnMETHODSnA prospective cohort study was conducted. The ThyPRO questionnaire was used in the QoL assessment.nnnRESULTSnThe HT patients experienced significantly worse hypothyroid symptoms and sex life than the BG patients. The improvement in QoL in the BG patients was significant after surgery in all ThyPRO domains. In the HT patients, the improvement was significant in all but two domains, eye symptoms and cognitive impairment. The best improvement in both groups was in overall QoL. None of the patients developed permanent consequences.nnnCONCLUSIONSnThe QoL of HT and BG patients is impaired and improves significantly after surgical treatment. Thyroidectomy should be considered as a treatment option in the HT patients more often as in the BG patients.

Survival and prognostic factors of anaplastic thyroid carcinoma.

Abstract Background : Anaplastic thyroid carcinoma (ATC) is relatively rare and represents one of the most aggressive tumours with poor prognosis, despite therapy. The aim of the study was to analyse demographic and clinical characteristics of ATC patients, and to identify survival rates and prognostic factors. Methods : In a retrospective study (1995–2005) ATC was found in 150 patients treated at our institution. Survival was calculated by Kaplan-Meier curve and log-rank test. Potential prognostic factors affecting survival were compared by Cox univariate and multivariate analyses. Results : Mean survival time was 56 weeks; median survival time was 16 weeks and 1 and 5-year survival were 17% and 8%. More than 10% died during the first month and 50% died up to the fourth month. Multivariate analysis showed that age, goitre and surgery were independent prognostic factors of survival in all ATC patients. Among operated patients, the extent of tumour resection, distant metastasis and multicentricity were independent prognostic risk factors of survival. Postoperative radiotherapy was a protective factor. Conclusions : There is still no successful treatment of ATC that can guarantee long term survival. Younger patients with pre-existing goitre, who undergo complete resection of unilocular early stage ATC without distant metastasis and with postoperative external radiotherapy, stand a better chance of long-term survival.

Retrospective evaluation of the incidental finding of 403 papillary thyroid microcarcinomas in 2466 patients undergoing thyroid surgery for presumed benign thyroid disease

BackgroundThe aim of our study was to investigate the incidence of papillary thyroid microcarcinoma (PTMC) in patients operated for benign thyroid diseases (BTD) and its relation to age, sex, extent of surgery and type of BTD.MethodsRetrospective study of 2466 patients who underwent thyroid surgery for BTD from 2008 to 2013. To determine independent predictors for PTMC we used three separate multivariate logistic regression models (MLR).ResultsThere were 2128 (86.3%) females and 338 (13.7%) males. PTMC was diagnosed in 345 (16.2%) females and 58 (17.2%) males. Age ranged from 14 to 85 years (mean 54 years). Sex and age were not related to the incidence of PTMC. The overall incidence of PTMC was 16.3%. The highest incidence was in Hashimoto thyroiditis (22.7%, χ2u2009=u200910.80, pu2009<u20090.001); and in patients with total/near-total thyroidectomy (17.7%, χ2u2009=u20097.05, pu2009<u20090.008). The lowest incidence (6.6%, χ2u2009=u20099.96, pu2009<u20090.001) was in a solitary hyperfunctional thyroid nodule (SHTN). According to MLR, Hashimoto thyroiditis (OR 1.54, 95% CI 1.15-2.05, pu2009<u20090.003) and SHTN (OR 0.43, 95% CI 0.21-0.87, pu2009<u20090.019) are independent predictors. Since the extent of surgery was an independent predictor (OR 1.45, 95% CI 1.10-1.92, pu2009=u20090.009) for all BTD, and sex and age were not; when the MLR model was adjusted for them, Graves disease (OR 0.72, 95% CI 0.53-0.99, pu2009<u20090.041) also proved to be an independent predictor.ConclusionsSex and age are not statistically related to the incidence of PTMC in BTD. The incidence of PTMC is higher in Hashimoto thyroiditis and patients with total/near-total thyroidectomy; and lower in patients with a SHTN and Graves disease.