25(OH) vitamin D deficiency in lymphoid malignancies, its prevalence and significance. Are we fully aware of it?

INTRODUCTION: Vitamin D has a role in cellular differentiation, proliferation, apoptosis, and angiogenesis and therefore is studied as a prognostic factor in cancer. The aim of our study was to assess the prevalence and significance of 25(OH)D deficiency in patients with lymphoid malignancies. METHODOLOGY: Between January 2014 and June 2016 at the Clinic for Hematology, Clinical Center of Serbia, Belgrade, the pretreatment serum level of 25(OH)D was determined in 133 (62 women/71 men, median age 58 (18-84) years) previously untreated patients with lymphoid malignancy using a chemiluminescent immunoassay. From their medical records, we noted the age, clinical stage, Eastern Cooperative Oncology Group Performance Scale (ECOG PS), nutritional status using the Nutritional Risk Score 2002 (NRS2002), the time of year, comorbidity index, progression, and progression-free survival (PFS) for a median of 20 (1-32) months. The optimal cutoff point for prediction of outcome was determined using the Maximally Selected Rank Statistics. RESULTS: There were 37 (27.8%) patients with the severe 25(OH)D deficiency ≤ 25 nmol/l, 80 (60.2%) with 25(OH)D deficiency 25-50 nmol/l, and 16 (12%) with 25(OH)D insufficiency 50-75 nmol/l. None of the patients had the desired normal level. There were significant differences between groups in regard to ECOG PS, NRS2002, type of lymphoma, and progression. The severely 25(OH)D-deficient patients had a shorter mean time until progression (P = 0.018). Cox regression analysis showed that 25(OH)D < 19.6 nmol/l remained the only significant parameter for PFS (HR = 2.921; 95% CI 1.307-6.529). CONCLUSION: The prevalence of 25(OH)D deficiency in the analyzed group of patients with lymphoid malignancies is high and greater in malnourished individuals. Patients with pretreatment serum 25(OH)D < 19.6 nmol/l had a significantly shorter PFS.

Oral sex related knowledge and oral sex behavior among homosexual and heterosexual men in Belgrade: A cross-sectional study.

BACKGROUND: Although the risk of sexually transmitted infections is far greater during vaginal and anal sex than during oral sex, increasing practice of oral sex and low rates of barrier method use will probably increase the relative importance of oral sex as a route of transmission for genital pathogens. AIMS: The aim of this study was to evaluate knowledge and attitudes about oral sex and sexually transmitted infections, as well as oral sex practices, both among heterosexuals and homosexual men and to compare those two groups. MATERIALS AND METHODS: In this cross-sectional study, data were collected from consecutive sexually active male patients who ever had oral sex and who attended counselling for sexually transmitted infections at the City Institute for Skin and Venereal Diseases in Belgrade from March to June 2016. One dermatologist interviewed all participants. RESULTS: The study included 359 men who ever had oral sex, 95 (26.5%) homosexual and 264 (73.5%) heterosexual men. In comparison with heterosexual men, homosexual men had considerably more lifetime sexual partners and oral sex partners during the past 3 months, and significantly more frequently practiced oral-anal sex. Oral-sex related knowledge of all participants was unsatisfactory [correct answers were given by 95 (26.5%) to 277 (77.2%) participants], but it was significantly better in homosexual men than in heterosexual. Frequency of condom use and human immunodeficiency virus testing was also significantly higher in the case of homosexual than heterosexual men. LIMITATIONS: The study was not performed in representative sample of population. It was restricted to the patients. Consequently it is questionable whether the results obtained could be generalized. CONCLUSION: Oral sex related knowledge deficits and risky oral sex practice exist in both homosexual and heterosexual men. These findings indicate a need for effective public health campaign and patient education about the risks of unprotected oral sex.