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1.
Catheter Cardiovasc Interv ; 100(6): 1090-1099, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36229946

RESUMO

OBJECTIVES: The PERFORMANCE I study was designed to evaluate the safety and feasibility of the Neuroguard IEP® System, a novel carotid stent system with an integrated embolic filter and post-dilatation balloon, to treat clinically significant carotid artery stenosis. BACKGROUND: The risk of major adverse events during carotid artery stenting is comparable to carotid endarterectomy, however, the risk of minor stroke remains higher with stenting. METHODS: In total, 67 patients undergoing carotid artery stenting were enrolled at nine centers in Europe. Follow-up assessments included neurological exams, duplex ultrasound, 12-lead electrocardiogram, and cardiac enzyme analysis. The primary endpoint was the 30-day composite rate of stroke, death, and myocardial infarctions versus a prespecified performance goal. Secondary endpoints included procedure success, device success, and target lesion revascularization. RESULTS: The study population was predominantly male (74.6%) with a mean age of 69.3 ± 8.9 years and 67% of subjects met at least one criterion placing them at an elevated risk for adverse events following carotid endarterectomy. All patients were treated successfully with the study device. There were no deaths or strokes within 30 days of the index procedure. One subject (1.5%) experienced a non-ST elevation myocardial infarction at day 17. The primary endpoint was met with a 30-day major adverse events rate of 1.5% (1/67). Through 12-month follow-up, there were no strokes, neurological deaths, target lesion revascularizations, or instances of in-stent-restenosis. CONCLUSIONS: Results from this study demonstrate the Neuroguard IEP system is safe and feasible with a stroke/death rate of 0% at 30 days. A large pivotal study is currently underway.


Assuntos
Estenose das Carótidas , Dispositivos de Proteção Embólica , Endarterectomia das Carótidas , Acidente Vascular Cerebral , Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Feminino , Estenose das Carótidas/complicações , Estenose das Carótidas/diagnóstico por imagem , Estenose das Carótidas/terapia , Stents , Dilatação , Resultado do Tratamento , Fatores de Tempo , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/prevenção & controle , Fatores de Risco
2.
Eur J Cancer Care (Engl) ; 31(1): e13526, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34672038

RESUMO

OBJECTIVES: The aim was to estimate the trend of incidence, mortality and mortality-to-incidence ratio (MIR) in Central Serbia in 1999-2018 and its possible association with the human development index (HDI). METHODS: In this study, cancer of unknown primary (CUP) was included as C77-C80 codes. Trend analysis was performed in the Joinpoint Regression Programme version 4.8.0.1. HDI combines life expectancy, educational attainment and gross national income. HDI values for Serbia are extracted from the global bank site. RESULTS: Joinpoint regression analysis of the age-standardised incidence rate of CUP showed a significantly increasing trend with annual percent change (APC) of 8.5% (95% confidence interval [CI] 3.0-14.3%) in males and 7.8% (95%CI 2.7-13.2) in females. The age-standardised mortality rate of CUP showed a significantly decreasing trend with APC of -1.7% (95%CI -2.8 to -0.5%) in males and -1.4% (95%CI -2.7 to -0.1%) in females. MIR showed a significantly decreasing trend with APC of -9.3% (95%CI -14.6 - -3.6%) in males and -7.1% (95%CI -10.5% to -4.2%) in females. The linear regression showed significant inverse association among HDI and the MIR of CUP in males (r2 = 0.464, p = 0.002) and in females (r2 = 0.612, p < 0.001). CONCLUSIONS: Decline of MIR was associated with HDI, suggesting that CUP prognosis follows socio-economic status.


Assuntos
Neoplasias Primárias Desconhecidas , Feminino , Humanos , Incidência , Expectativa de Vida , Masculino , Sistema de Registros , Sérvia/epidemiologia
3.
Int Wound J ; 19(2): 447-459, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34342156

RESUMO

The study aims to estimate the cost-effectiveness of superabsorbent wound dressings compared to the standard-of-care (SoC) dressings mix for treatment of patients with moderate-to-highly exuding leg ulcers in the German healthcare settings. A model-based cost-effectiveness analysis was conducted from the German statutory health insurance perspective, following German specific and international recommendations of good research practice. An individual-level (microsimulation) state-transition model has been used with a cycle length of 1 week and time horizon of 6 months. Several comprehensive systematic reviews were conducted to inform all model inputs, including clinical parameters, efficacy, quality of life, resources utilisation, and cost inputs. In addition, primary data from two clinical trials were used. Based on this cost-effectiveness analysis, using superabsorbent wound dressings instead of the SoC dressings of patients with moderate-to-highly exuding leg ulcers in Germany can lead to an improved healing rate of 2.57% (benefit ratio 1.08), improved health-related quality of life of 0.152 quality-adjusted life weeks, and total direct cost savings of €771 per patient in 6 months. Robustness of results was confirmed in sensitivity and scenario analyses.


Assuntos
Úlcera da Perna , Qualidade de Vida , Bandagens , Análise Custo-Benefício , Humanos , Úlcera da Perna/terapia , Cicatrização
4.
J Sports Sci Med ; 20(1): 133-141, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33707996

RESUMO

Strength training can improve myriad health parameters in elderly cohorts. Although potentially more appropriate for the elderly, low-load resistance training protocols have been less investigated. We aimed to examine the effects of 12 weeks of chair-based, low-load resistance training with elastic band (EBT) on functional fitness and metabolic biomarkers in older women. One hundred sixty-eight women were allocated randomly to an elastic band resistance training (EBT, n = 86, 75.7 ± 8.9 years, 71.3 ± 12.2 kg) or a control group (CON, n = 82, 74.5 ± 8.2years, 70.6 ± 12.0 kg). RT protocol consisted of periodized chair-based, low-load whole-body resistance exercises (2 sets, 12-15 repetitions, 40-60% of one repetition maximum-1RM) using an elastic band, twice weekly for 12 weeks. The resistance training program was generally designed to maintain internal load over time, provided with increasing intensity using various elastic bands (Thera-Band). Functional fitness (30-s Chair Stand,30-s Arm Curl, 2-min Step Test, Chair Sit-and-Reach, Back Scratch, 8-Foot Up-and-Go, Handgrip Strength) and metabolic markers (Fasting blood glucose, triglycerides, total cholesterol, high (HDL) and low (LDL) density lipoprotein) were measured before and after the training period. To detect pre/post intervention changes and between group- differences 2x2 repeated measures ANOVA was applied. Significant improvements over time for all fitness variables for EBT comparing to CON were obtained (F = 12.78, p < 0.05 for 30-s Chair Stand; F = 14.04, p < 0.05 for 30-s Arm Curl; F = 5.18, p < 0.05 for 2-min Step Test; F = 10.90, p < 0.05 for Chair Sit-and-Reach; F = 16.57, p < 0.05 for Back Scratch; F = 11.79, p < 0.05 for 8-foot Up-and-Go; and F = 29.25, p < 0.05 for Handgrip Strength). In addition, significant improvements over time for all but one (triglycerides) biomarkers for EBT comparing to CON were obtained (F = 7.30, p < 0.05 for blood sugar levels; F = 13.36, p < 0.05 for total cholesterol; F = 8.61, p < 0.05 for HDL; and F = 11.53, p < 0.05 for LDL). Furthermore, the participants' adherence to training sessions of over 90% was reported. In conclusion, 12 weeks of EBT is safe and beneficial for improving health-related fitness and metabolic biomarkers in older women and seems to be viable model to ensure a high training adherence rate.


Assuntos
Biomarcadores/sangue , Aptidão Física/fisiologia , Desempenho Físico Funcional , Treinamento Resistido/métodos , Postura Sentada , Idoso , Análise de Variância , Glicemia/análise , Colesterol/sangue , Jejum/sangue , Feminino , Força da Mão/fisiologia , Humanos , Lipoproteínas LDL/sangue , Treinamento Resistido/instrumentação , Sérvia , Método Simples-Cego , Triglicerídeos/sangue
5.
J Transl Med ; 18(1): 142, 2020 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-32228627

RESUMO

OBJECTIVE: To observe the effect of rapid weight loss (RWL) methods over 3 days on muscle damage in judokas. METHODS: Eighteen judokas participated in this crossover study, meaning that judo athletes were subjected to exercise-only phase (4 days) and RWL phase (3 days). Subjects were tested for myoglobin, creatine kinase, aldolase, hemoglobin, and hematocrit values on seven consecutive days. These biomarkers served as indicators of acute muscle damage. RESULTS: During the exercise-only phase, no significant changes were observed. Myoglobin (Mb) (p < 0.001), creatine kinase (CK) (p < 0.001) and aldolase (ALD) (p < 0.001) significantly increased only during the RWL phase, as well as hemoglobin (Hb) (p < 0.001) and hematocrit (Hct) (p < 0.005) values. It was detected that peak values for muscle damage biomarkers were reached on the sixth day, while Hct and Hb values were the highest on the seventh day of the study. CONCLUSION: Our study showed significant muscle damage induced by RWL. The prevalence of RWL use by judokas is high but firm scientific evidence is lacking in the evaluation of the current practice of it. Therefore, further knowledge must be gained to evaluate the effectiveness of RWL on performance and its impact on judokas' wellbeing.


Assuntos
Artes Marciais , Redução de Peso , Atletas , Estudos Cross-Over , Humanos , Músculo Esquelético
6.
Cent Eur J Public Health ; 28(3): 193-197, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32997474

RESUMO

OBJECTIVE: The aim of this study was to examine subjective sensitivity to noise of the citizens of Nis and its impact on their non-auditory health effects. METHODS: This study was designed as a cross-sectional questionnaire survey among 908 adult residents of Nis, Serbia, of whom 387 were men (42.6%) and 521 women (57.4%). Streets with day Leq ≥ 55 dB(A) and night Leq ≥ 45 dB(A) were regarded as noisy and those with day Leq ≤ 55 dB(A) and night Leq ≤ 45 dB(A) were regarded as quiet, in accordance with WHO recommendations. Noise sensitivity was measured with the Weinstein's Noise Sensitivity Scale. Logistic regression analysis was used to assess the impact of noise sensitivity on non-auditory health effects. RESULTS: The study showed that the values of the Weinstein's Noise Sensitivity Scale were significantly higher for those surveyed in the noisy zone. Multiple regression analysis revealed a significant impact of noise sensitivity on night-sleep duration (p = 0.04), subjective assessment of sleep quality (p < 0.01) and daily rest disruption (p < 0.001). CONCLUSION: Based on the study results, it can be confirmed that noise sensitivity has an important role in causing non-auditory health effects among adults.


Assuntos
Limiar Auditivo , Nível de Saúde , Ruído/efeitos adversos , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Sérvia , Inquéritos e Questionários
7.
Medicina (Kaunas) ; 56(8)2020 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-32823648

RESUMO

Background and objectives: Persistent infection with carcinogenic human papillomavirus (HPV) is the leading cause of cervical cancer. The study explored students' knowledge about cervical cancer and awareness of human papillomavirus and the HPV vaccine. Materials and Methods: A questionnaire-based survey was carried out among 1616 first-year female college students at the University of Nis. It examined socio-demographic characteristics, measured the score of knowledge about cervical cancer, assessed awareness regarding HPV and the HPV vaccine and inquired about the source of information about cervical cancer and HPV. Results: The average cervical cancer knowledge score was 16.35 ± 7.92 (min 0, max 30), with medical professional education, parents' education level, place of residence and relationship status having significant effects on the score. The awareness about HPV and the HPV vaccine was low, with only 14.2% of students having heard about both HPV and its vaccine. The most commonly reported sources of information were the media, while the most competent one was organized health education. Conclusions: Health promotion campaigns and educational programs are necessary in order to reduce cervical cancer burden and should be directed particularly towards those who have demonstrated low cervical cancer knowledge and low awareness regarding HPV and its vaccine.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Infecções por Papillomavirus/prevenção & controle , Vacinas contra Papillomavirus , Estudantes/psicologia , Neoplasias do Colo do Útero/prevenção & controle , Neoplasias do Colo do Útero/virologia , Estudos Transversais , Feminino , Humanos , Sérvia , Fatores Socioeconômicos , Adulto Jovem
8.
BMC Infect Dis ; 14: 68, 2014 Feb 08.
Artigo em Inglês | MEDLINE | ID: mdl-24507413

RESUMO

BACKGROUND: The Northern part of Serbia is hyperendemic-endemic for canine dirofilarioses. Considering this fact, many human dirofilarial infections could be expected, however only about 30 cases in Serbia have been described until today. Aims of this survey were to assess the people reactivity to the antigens of D. repens and D. immitis and to identify risk factors for the contact exposure. METHODS: Investigation included sera taken from 297 people (179 women and 118 men) living in different areas of Serbia (Pancevo, Novi Sad, Zajecar, Leskovac, Vranje, Nis, Pirot). Sera were analysed by means of two indirect enzyme-linked immunosorbent (ELISA) home-designed that use as antigens adult somatic/metabolic polyproteins of D. repens (DR) and D. immitis (DI), respectively. The results were elaborated using the statistical method of descriptive and quantitative analysis. RESULTS: Significant differences by area in the reactivity of human sera to dirofilarial antigens were not observed (p = 0.056). A high seroreactivity was demonstrated in people from the towns of northern Serbia (Pancevo = 27,1%; Novi Sad = 16,3%), as well as in people from Zajecar (eastern Serbia = 15,8%) and Vranje (southern Serbia = 15,1%). No differences were evidenced between people reactivity to polyproteins of the two dirofilarial species, nor differences related to the gender of examinees. Factor risks evidenced were: i) place of residence; ii) spending work time outdoors during the mosquito season; iii) spending time outdoors and nearby rivers, lakes, swamps or canals; unespectedly, iv) cat owning. CONCLUSION: The findings emerging from this investigation indicate that clinicians and public health authorities should pay greater attention to this zoonosis. Continuing education and training of physicians will greatly contribute to the knowledge of the actual impact of filarial worms on animal and public health, and allow for the planning of suitable measures to prevent the infections.


Assuntos
Antígenos de Helmintos/imunologia , Dirofilaria immitis/imunologia , Dirofilaria repens/imunologia , Dirofilariose/imunologia , Zoonoses/imunologia , Adolescente , Adulto , Animais , Anticorpos Anti-Helmínticos/imunologia , Gatos , Criança , Dirofilariose/parasitologia , Cães , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Sérvia , Adulto Jovem , Zoonoses/parasitologia
9.
Stud Health Technol Inform ; 318: 132-137, 2024 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-39320194

RESUMO

Considering consumer preferences, this paper proposes computer-readable policy expressions to govern data sharing and use in consent-based health information exchange. Consent automation is an essential component of digital health transformation efforts, enabling better consumer choices in using their sensitive data while unlocking new values through policy-aware workflow expressions. The approach is based on the HL7 FHIR standard while using the obligation and responsibility concepts formally defined in the ISO ODP Enterprise Language (ODP-EL) standard. These concepts were expressed using a domain specific language (DSL) to support code generation for integration with digital health applications. The approach enables improved interoperability, considering consent, privacy, security requirements, and the ability to adopt new business, regulative or jurisdictional policies. Additionally, it accommodates generative AI solutions for faster alignment with existing document-based policies, ensuring clear provenance. Finally, consent automation and a broader policy framework in the context of the latest Australian Government initiatives in digital health are discussed.


Assuntos
Troca de Informação em Saúde , Consentimento Livre e Esclarecido , Humanos , Austrália , Confidencialidade , Interoperabilidade da Informação em Saúde
10.
Stud Health Technol Inform ; 310: 1368-1369, 2024 Jan 25.
Artigo em Inglês | MEDLINE | ID: mdl-38270047

RESUMO

We present a framework for digital health consent in support of computable expression of medico-legal policies to govern consumer data sharing across providers. The approach is aligned with HL7 FHIR© standard, and is based on generic formalism for policy modelling, grounded in normative systems and deontic logic. We show the use of the framework for a clinical research scenario.


Assuntos
Saúde Digital , Políticas , Consentimento Livre e Esclarecido
11.
Longit Life Course Stud ; 15(3): 394-406, 2024 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-38954409

RESUMO

This study aims to evaluate the temporal trend in the quality of cause-of-death data and garbage code profiles and to determine its association with socio-economic status in Serbia. A longitudinal study was assessed using data from mortality registers from 2005 to 2019. Computer application Analysis of Causes of National Deaths for Action (ANACONDA) calculates the distribution of garbage codes by severity and composite quality indicator: Vital Statistics Performance Index for Quality (VSPI(Q)). A relationship between VSPI(Q) and country development was estimated by analysing two socio-economic indicators: the Socio-demographic Index and the Human Development Index (HDI). Serbia indicates progress in strengthening cause-of-death statistics. The steady upward trend of the VSPI(Q) index has risen from 55.6 (medium quality) to 70.2 (high quality) over the examined years. Significant reduction of 'Insufficiently specified causes with limited impact' (Level 4) and an increase in the trend of 'High-impact garbage codes' (Levels 1 to 3) were evident. Decreased deaths of no policy value (annual percentage change of -1.41%) have manifested since 2014. A strong positive association between VSPI(Q) and socio-economic indicators was assessed, where the HDI has shown a stronger association with VSPI(Q). Improved socio-economic conditions on the national level are followed by enhanced cause-of-death data quality. Upcoming actions to improve quality should be directed at high-impact garbage codes. The study underlines the need to prioritise the education and training of physicians with a crucial role in death certification to overcome many cause-of-death quality issues identified in this assessment.


Assuntos
Causas de Morte , Humanos , Sérvia/epidemiologia , Causas de Morte/tendências , Estudos Longitudinais , Fatores Socioeconômicos , Sistema de Registros , Confiabilidade dos Dados , Estatísticas Vitais
12.
Iran J Public Health ; 53(7): 1528-1536, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39086425

RESUMO

Background: We aimed to evaluate the quality of the cause of death (COD) concerning mortality patterns and completeness of death registration to identify areas for improvement in Serbia. Methods: COD data collected from the mortality register in Serbia from 2005 to 2019 (1540615 deaths) were analyzed with the software Analysis of National Causes of Death for Action. The Vital Statistics Performance Index for Quality (VSPI(Q)) is estimated for the overall COD data quality. Results: The completeness of death certification was higher than 98%. Usable underlying COD was registered in 57%, 24.1% with an unusable and 18.6% with insufficiently specified COD. The VSPI(Q) was 67.2%, denoting medium quality. The typical error was using intermediate COD (24.7% of all deaths), while 13.2% and 8.5% of all garbage codes (GC) belonged to the Very High and High Severity classes. The leading underlying COD is unspecified cardiomyopathy. The analysis revealed that 39.1% of GC has been redistributed to non-communicable diseases, 2.5% to external causes and 1.1% to communicable diseases. Conclusion: In the 15 years' worth of data analyzed, the true underlying COD, in many cases, was ill-defined, indicating that COD data at the national level could be distorted. The additional and continuous professional education of medical students as well as physicians is needed. It should focus on the most common GC among the leading COD and acquiring skills in certifying external causes of death.

13.
Vasa ; 42(3): 168-76, 2013 May.
Artigo em Inglês | MEDLINE | ID: mdl-23644368

RESUMO

This document by an expert panel of the International Society for Neurovascular Disease is aimed at presenting current technique and interpretation of catheter venography of the internal jugular veins, azygous vein and other veins draining the central nervous system. Although interventionalists agree on general rules, significant differences exist in terms of details of venographic technique and interpretations of angiographic pictures. It is also suggested that debatable findings should be investigated using multimodal diagnostics. Finally, the authors recommend that any publication on chronic cerebrospinal venous insufficiency should include detailed description of venographic technique used, to facilitate a comparison of published results in this area.


Assuntos
Veia Ázigos/diagnóstico por imagem , Cateterismo Venoso Central/normas , Veias Jugulares/diagnóstico por imagem , Flebografia/normas , Doenças Vasculares/diagnóstico por imagem , Cateterismo Venoso Central/efeitos adversos , Veias Cerebrais/diagnóstico por imagem , Transtornos Cerebrovasculares/diagnóstico por imagem , Doença Crônica , Constrição Patológica , Humanos , Flebografia/efeitos adversos , Valor Preditivo dos Testes , Prognóstico , Medição de Risco , Ultrassonografia de Intervenção , Doenças Vasculares/terapia , Insuficiência Venosa/diagnóstico por imagem
14.
Cent Eur J Public Health ; 21(3): 140-5, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24344537

RESUMO

OBJECTIVE: Mortality has been shown to increase with heat waves. Serbia experienced the hottest heat wave in July 2007. In this study, we examined patterns of non-traumatic excess mortality in Belgrade during this event. METHODS: The numbers of deaths observed during the 9-day heat wave were compared to those expected on the basis of mortality rates reported for the previous eight years and two following years. Excess mortality was analyzed by age, gender and cause of death. RESULTS: There was a total of 167 excess deaths (38%) between 16 and 24 July. People aged 75 years and older accounted for 151 (90%) of all excess deaths. An increase of mortality among elderly was 76% in comparison to the baseline mortality. Excess female mortality was over two times higher than excess male mortality (54% : 23%). The biggest increase in mortality was from diabetes mellitus (286%), chronic kidney disease (200%), respiratory system diseases (73%), and nervous system diseases (67%). Cardiovascular and malignant neoplasms mortality accounted for the highest absolute numbers of excess deaths (77 and 49, respectively). There was no decrease in mortality in the 60-day period after the heat wave. CONCLUSIONS: There are several causes of an increase in heat-related mortality. The most vulnerable population group is the elderly females.


Assuntos
Mortalidade/tendências , Fatores Etários , Doença Crônica/mortalidade , Humanos , Sérvia/epidemiologia , Fatores Sexuais
15.
Children (Basel) ; 10(10)2023 Oct 08.
Artigo em Inglês | MEDLINE | ID: mdl-37892327

RESUMO

The aim of this study was to determine urban-rural and regional differences in anthropometric characteristics among adolescents aged 12-14, as well as to present the prevalence of weight status. A total of 534 adolescents aged 12-14 from primary schools across Montenegro participated in this cross-sectional study (283 boys, aged 13.52 ± 0.42, body height 169.43 ± 8.89, body weight 60.54 ± 13.47; 251 girls, aged 13.51 ± 0.40, body height 165.54 ± 6.67, body weight 55.28 ± 9.27). The sample was divided by geographic region in Montenegro into northern, central, and coastal regions, and according to settlement type into urban and rural inhabitants. Anthropometric characteristics were assessed using a battery of seven variables: arm span (AS); body height (BH); body weight (BW); waist circumference (WC); hip circumference (HC); body mass index (BMI); and waist-to-hip ratio (WHR). BMI was categorized based on the World Health Organization's (WHO) cut-offs. The results indicate that girls from urban areas exhibited significantly greater body height and lower BMI values compared to their rural counterparts. Similarly, boys from urban areas also demonstrated lower BMI values compared to their rural peers. However, no statistically significant differences were observed in other anthropometric characteristics between these two groups of adolescents. Based on analysis of variance (ANOVA) and post-hoc analysis, it was found that girls from central areas had significantly greater body height compared to those from northern and coastal areas. Likewise, boys from northern areas showed higher body mass and BMI values compared to those from central areas. Additionally, both boys and girls from central areas had higher values compared to those from coastal areas. Nevertheless, no significant differences were detected in other anthropometric characteristics among adolescents from these regions. This study identified significant differences in anthropometric parameters among participants based on urban-rural status and within regional divisions. However, further research encompassing a larger sub-sample and a broader array of anthropometric variables is needed to draw a more comprehensive conclusion.

16.
Cent Eur J Public Health ; 20(2): 135-8, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22966739

RESUMO

OBJECTIVES: Seasonal fluctuations in mortality are associated with age, outdoor temperature, influenza, health care provision, lifestyle risk factors and economic factors. In the Republic of Serbia almost one half of the Roma population lives in poverty and their housing conditions are very poor. The aim of this paper is to describe and compare excess winter mortality (EWM) in Roma and non-Roma population in Serbia from 1992 to 2007. METHODS: Using the national mortality database, this study compares EWM index and rates in Roma and general populations in Serbia. Mean winter temperature and ethnicity are analysed against the results for relative EWM by multiple linear regression adjusted for age. RESULTS: Frequency analysis showed that Roma population had significantly higher EWM rate per 10,000 (129.2 vs. 76.6) for all causes, all respiratory diseases (26.5 vs. 8.0), and chronic lower respiratory diseases (23.0 vs. 5.2) in comparison to non-Roma population. Influenza and pneumonia related deaths represented a small proportion of EWM in both populations. Cardiovascular EWM rate was slightly higher among non-Roma population. Regression analysis demonstrates that Roma ethnicity was associated with significant increase of respiratory EWM rate (regression coefficient (B) = 1.49; 95% CI: 0.45-2.54). There was no relationship between ethnicity and cardiovascular and all causes EWM rates. CONCLUSIONS: Although both Roma and non-Roma populations in Serbia suffer from very high rates of excess winter mortality, Roma are significantly more vulnerable. EWM rate from chronic lower respiratory diseases is more than four times higher among Roma people and suggests that they represent one of the most important health problems in Roma population in Serbia.


Assuntos
Etnicidade/estatística & dados numéricos , Mortalidade/tendências , Doenças Cardiovasculares/mortalidade , Causas de Morte , Temperatura Baixa , Disparidades nos Níveis de Saúde , Humanos , Fatores de Risco , Estações do Ano , Sérvia/epidemiologia , Fatores Socioeconômicos
17.
Clin Neuroradiol ; 32(3): 829-837, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35175361

RESUMO

BACKGROUND: In the absence of an automated software analysis, the role of computed tomography perfusion (CTP) in a real time clinical practice is not well established. We evaluated the clinical significance of a widely accessible and simple visual grading scale of CTP in the anterior circulation of acute ischemic stroke (AIS) patients treated with mechanical thrombectomy (MT). METHODS: The single center consecutive CT investigations of AIS patients treated with MT in the anterior circulation have been evaluated retrospectively. ASPECT score and collateral circulation evaluation based on the Maas score were determined. Time to peak parametric maps, derived from CTP, were graded into four categories, from least to most favorable. The primary endpoint was functional outcome evaluated as modified Rankin Scale (mRS) ≤ 2 at 90 days after MT. RESULTS: We included 318 patients in the analysis; 142 (45%) patients had mRS ≤ 2 after 90 days, mortality rate was 24%. Higher CTP and Maas score were significantly correlated with better clinical outcome (Pearson χ2 25.0 and 37.7, respectively; p < 0.01). Collateral circulation and CTP grades were strongly interrelated (Pearson χ2 78.6; p < 0.01). The CTP grade demonstrated statistically significant independent correlation with the clinical outcome irrespective of the collateral circulation grade, ASPECT score and age (OR 2.5; p = 0.011). The correlation was more pronounced in patients with normal collateral circulation (OR 3.27; p = 0.029). CONCLUSION: We demonstrated that both visually graded CTP and collateral circulation grade strongly correlated with the clinical outcome of MT in the anterior circulation of AIS patients. Importantly, CTP correlated with the clinical outcome independent of the collateral circulation.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Circulação Cerebrovascular , Circulação Colateral , Angiografia por Tomografia Computadorizada , Perfusão , Imagem de Perfusão , Estudos Retrospectivos , Trombectomia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
18.
Artigo em Inglês | MEDLINE | ID: mdl-36554613

RESUMO

(1) Background: Idiopathic scoliosis can be defined as a complex three-dimensional deformity of the spine and trunk, which occurs in basically healthy children. Schroth scoliosis-specific exercises have shown good results in reducing idiopathic scoliosis progression. This study aimed to critically evaluate the effect size of Schroth's method through a systematic review and meta-analysis. (2) Methods: Four databases were included in the search: PubMed, Cochrane Library, Web of Science, and Google Scholar. The following keywords were used: "Schroth exercise", "idiopathic scoliosis", "Cobb angle", "angle of trunk rotation", and "quality of life". Only articles written in English that met the following criteria were included in our study: subjects who had idiopathic scoliosis, the Schroth method was applied, and Cobb angle or angle of trunk rotation or quality of life as outcomes. (3) Results: Ten randomized controlled trials were included in this study. The effect size of the Schroth exercise ranged from almost moderate to large, for the outcomes used: Cobb angle (ES = -0.492, p ˂ 0.005); ATR (ES = -0.471, p = 0.013); QoL (ES = 1.087, p ˂ 0.001). (4) Conclusions: The current meta-analysis indicates that the Schroth method has a positive effect on subjects with idiopathic scoliosis.


Assuntos
Escoliose , Criança , Humanos , Escoliose/terapia , Qualidade de Vida , Resultado do Tratamento , Coluna Vertebral , Terapia por Exercício/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
19.
J Clin Med ; 11(19)2022 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-36233842

RESUMO

The precise characterization of cerebral thrombi prior to an interventional procedure can ease the procedure and increase its success. This study investigates how well cerebral thrombi can be characterized by computed tomography (CT), magnetic resonance (MR) and histology, and how parameters obtained by these methods correlate with each other as well as with the interventional procedure and clinical parameters. Cerebral thrombi of 25 patients diagnosed by CT with acute ischemic stroke were acquired by mechanical thrombectomy and, subsequently, scanned by a high spatial-resolution 3D MRI including T1-weighted imaging, apparent diffusion coefficient (ADC), T2 mapping and then finally analyzed by histology. Parameter pairs with Pearson correlation coefficient more than 0.5 were further considered by explaining a possible cause for the correlation and its impact on the difficulty of the interventional procedure and the treatment outcome. Significant correlations were found between the variability of ADC and the duration of the mechanical recanalization, the deviation in average Hounsfield units (HU) and the number of passes with the thrombectomy device, length of the thrombus, its RBC content and many others. This study also demonstrates the clinical potentials of high spatial resolution multiparametric MRI in characterization of thrombi and its use for interventional procedure planning.

20.
Artigo em Inglês | MEDLINE | ID: mdl-34065525

RESUMO

This study aimed to consolidate the body height, body weight, BMI, and nutrition status data of the overall young male population from the Municipality of Berane in order to assess the trajectories of those variables from 1979 to 1987. The sample of respondents included 8740 adolescents who were divided into nine groups according to their age. The sample of variables included body height, body weight, body mass index, and nutrition status, which were presented based on a long-established BMI categorization (underweight, normal weight, pre-obese, and obese). The descriptive statistics are expressed as the mean and standard deviation for each variable; the analysis of nutrition status was calculated based on BMI, while LSD post hoc testing with ANOVA was employed to investigate differences between the means. The results indicate that a secular trend is visible regarding body height and body weight, while no trend is visible for the BMI and nutrition status. This study's contribution is that it provides insight into more recently published data for the studied period and in this municipality, which can significantly aid in following the secular trend throughout Montenegro.


Assuntos
Estatura , Estado Nutricional , Adolescente , Índice de Massa Corporal , Peso Corporal , Humanos , Masculino , Montenegro
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