The effectiveness of two different sub-bandage pressure values on healing and quality of life outcomes for patients with venous leg ulcers.

Introduction: Venous ulcers account for over 80% of chronic wounds in the lower extremities. Venous ulcers lead to a significant decrease in the patients' quality of life. Aim: To compare the effectiveness of two different sub-bandage pressure values on healing and quality of life outcomes. Material and methods: The study included 116 outpatients with venous leg ulcers (VLUs), one group with a moderate compression pressure of 35-40 mm Hg and the second with a high pressure > 45 mm Hg. The Kaplan-Meier curve and log rank test were used to estimate healing by type of compression. Quality of life measures included: Quality of Life Index (QL), Numeric Pain Rating Scale (NPRS) and Geriatric Depression Scale (GDS). Patients were followed for 24 weeks. Results: Kaplan-Maier analysis showed that a high pressure leads to a higher proportion of healed VLUs, compared to the moderate pressure (p = 0.011). QL, GDS and NPRS at the beginning were equalized between the groups. In patients with a high compression, there was a statistically significant increase in QL (p = 0.005), decrease in GDS (p = 0.040) and NPRS (p = 0.002) during 24 weeks. In patients with moderate compressions there was a statistically significant increase in QL (p = 0.013). Conclusions: Patients who received high pressure, healed faster. When a high pressure was applied, there was a statistically significant increase in QL, decrease in GDS and NPRS compared to the group of patients to whom the moderate pressure was applied.

Assessment of the quality of life in breast cancer depending on the surgical treatment.

PURPOSE: The objective of the study is to describe QoL in women who have undergone surgical treatment for breast cancer (BC). The focus of the description is the differences in QoL between women treated by modified radical mastectomy (MRM) and women who underwent breast-conserving surgery (BCS) at the Breast and Endocrine Surgery Department of the Clinical Center of Nis, Serbia. METHOD: From January 1, 2014, until December 31, 2017, 300 patients were treated with BCS and 300 patients with MRM. To assess the QOL, a total of 600 BC patients completed the WHOQOL-BREF questionnaires. The results were analyzed using the t test and chi-square test. WHOQOL produces a quality of life profile. It derives four domain scores: physical health, psychological, social relationships, and environment. Social and demographic factors (age, education, marital status) were collected in both groups. RESULT: In all four domains, patients treated with conserving surgeries scored higher than patients treated with radical mastectomy. This result was controlled for a set of demographic variables. The differences in QoL scores are present on all levels of controlling variables. CONCLUSION: According to the results of this study, the QoL in women after an MRM is significantly lower than the QoL in women after BCS. It is especially true for the environment domain. Conserving surgery should be recommended and specific, and patient-centered interventions for increasing QoL of the patients who opted for radical mastectomy should be designed. The intervention should focus on social and environmental domains.

Characteristics and outcomes of patients with multifocal/multicentric and unifocal breast cancer.

PURPOSE: The clinical behavior and outcome of multifocal (MF) and multicentric (MC) breast tumors are not well characterized. The purpose of this study was to compare the prognosis of MF/MC tumors with unifocal (UF)tumors and its correlation with other pathological characteristics and patient outcomes. METHODS: Eighty-three patients with MC/MF breast cancer and 501 with UF breast cancer treated at the Surgical Clinic Nis were studied. We compared MC/MF and UF breast cancer patients with respect to demographics, tumor characteristics- adjuvant systemic therapy, local recurrence-free survival (LRFS) and overall survival (OS). RESULTS: There was no significant statistical difference between the two groups with respect to mean age at diagnosis, tumor grade, nodal status, estrogen receptor status, lymphovascular invasion (LVI) and adjuvant systemic therapy. The MC/MF group had more patients with modified radical mastectomy and the UF group had more patients with breast-conserving surgery. Cox multivariate regression analysis showed that the regional lymph node metastases and LVI were the most important predictors of 5-year OS rate. During this period, locoregional recurrence was registered in 29 (5.78%) patients in the UF group and in 5 (6.02%) patients in the MF/MC group (p=0.48). No statistically significant differences in the 5-year LRFS and OS between the two groups were noticed. CONCLUSION: The prognostic value of MF/MC disease is still not well known, although some studies have suggested that it is associated with a worse prognosis. This study showed no statistically significant difference in the 5-year LRFS and OS between UF and MF/MC groups.

Prevalence of hypertension in adults in the Sumadija district, Serbia -a cross-sectional study.

BACKGROUND/AIM: World Health Organization (WHO) studies on the global level have shown that one of the major problems of the public health is hypertension. Blood pressure level greater than 140/90 mmHg is directly and predictively linked to other cardiovascular diseases. The aim of this research was to determine the prevalence of hypertension and the risk groups among the adult population in the Sumadija District, Serbia. METHODS: This cross-sectional study included 1.669 elderly population of the Sumadija District, aged 25-74. The study was performed according to the protocol of the Countrywide Integrated Noncommunicable Disease Intervention (CINDI) international program. RESULTS: In the Sumadija District more than a half of the population aged 25-74 suffers from hypertension (53%). In the Sumadija District 9% of population has undiagnosed hypertension. In the group of people familiar with their high blood pressure problems, good disease control is achieved in only 46% of them. Statistically, hypertension occurs more frequently in males aged 45-74, of lower education, and in rural population. This is the target group for implementation of the high risk strategy. Statistically, there is a higher prevalence of hypertension in people suffering from myocardial infarction (p =0.04), angina pectoris (p = 0.00), other cardiac diseases (cardiac insufficiency) (p = 0.00) and cerebrovascular crises (p = 0.04). CONCLUSION: A continuous increase of patients with hypertension, coupled with the developed complications and increase in cardiovascular diseases as a cause of death, points to the lack of effective access to prevention and early detection of these diseases in the primary health care among the risk groups in Sumadija.