Demographic and socioeconomic inequalities in ideal cardiovascular health: A systematic review and meta-analysis.

BACKGROUND: In 2010, the American Heart Association introduced a new concept of ideal cardiovascular health (CVH) defined as the simultaneous presence of 7 favorable CVH metrics (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting blood glucose). The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the prevalence of ideal CVH, and each of the ideal CVH metrics as well as the relationship between socio-demographic determinants and ideal CVH. METHODS: A comprehensive literature search was conducted in Medline and Scopus databases for studies published between 1 January 2010 and 30 June 2020. A total of 50 studies including 2,148,470 participants were analyzed. Associations were estimated using DerSimonian-Laird random-effect models. Heterogeneity was investigated through subgroup analyses, Q-test, and I2 statistics. RESULTS: This study showed a low prevalence of ideal CVH defining as 6 and 7 ideal metrics (3.3%). Among seven ideal CVH metrics, smoking was the best metric (71%), while the poorest CVH metric was a healthy diet (5.8%). Gender was a statistically significant moderator of ideal smoking (81% in females and 60% in males) and ideal blood pressure (42% in females and 30% in males). Females and young adults had better CVH status compared to males and older adults. Also, more educated and better-off individuals had a greater number of ideal CVH metrics. CONCLUSIONS: To the best of our knowledge, this is the first systematic review on the relationship between participants' socioeconomic status and ideal CVH. The results suggest that the prevalence of ideal CVH and most metrics was unsatisfactory. In order to achieve the improvement of the CVH metrics and the overall ideal CVH, nationwide prevention efforts at the population and individual levels are urgently needed.

Adolescents' beliefs and perceptions of acne vulgaris: A cross-sectional study in Montenegrin schoolchildren.

BACKGROUND: Acne is a common chronic inflammatory skin disease with a high prevalence in adolescent and early adult years. The aim of this study was to assess the self-perceived beliefs of Montenegrin secondary school pupils regarding the acne aggravating and ameliorating factors. METHODS: This cross-sectional survey of the pupils was conducted during October and November 2020 in four randomly selected public secondary schools in Podgorica, Montenegro. All 500 pupils were asked to fill in a questionnaire that included questions on age, sex, presence of acne, perceived acne aggravating and ameliorating factors, and sources of their information about acne. RESULTS: A total of 500 pupils, 234 (46.8%) boys, and 266 (53.2%) girls, aged 14-17 years, participated in the study. Acne was self-reported in 249 (49.8%) pupils, whereas 251 (50.2%) did not report acne. Factors most often believed to aggravate acne were inadequate face washing (85.0%), hormones (84.0%), sweets (82.0%), greasy food (72.6%), makeup (71.2%), and stress (67.8%). Overall the most prevalent acne ameliorating factors were cosmetic treatment (80.4%), increased water consumption (77.6%), a diet change to a healthier food choice (77.4%), and being on school holidays (62.2%). Girls reported more frequently that genetics, stress, sweets consumption, inadequate face wash, and makeup are acne exacerbating factors, whilst cosmetic treatment, increased water consumption, smoking, and being on school holidays are acne ameliorating factors. Boys more frequently considered the benefit of losing weight. There was no statistically significant difference between pupils with and without acne in perceived factors, except for cosmetic treatment. Those with acne more frequently believed in the benefits of cosmetic treatment. CONCLUSIONS: Many adolescents' self-perceived beliefs about factors that aggravate and ameliorate acne are myths and misconceptions without evidence-based justification. More efforts are needed to educate pupils about the acne aggravating and ameliorating factors, its health-related consequences, and the treatment possibilities.

Predictors of burnout among Belgrade veterinary students: A cross-sectional study.

BACKGROUND: To the best of our knowledge, studies are lacking on burnout among veterinary students in Serbia, and this is the first study trying to address such a problem. Therefore, the aim of this cross-sectional study was to investigate the predictors of burnout among Belgrade veterinary students. METHODS: Maslach Burnout Inventory (MBI) and anonymous structured questionnaire addressed to personal data, health habits and stressful influence of educational process were applied among 496 respondents from a total of 1113 students from all grades in spring semester 2014 (response rate 44.6%). RESULTS: The prevalence of burnout was 43.3%. High scores on depersonalization and emotional exhaustion scales of MBI were found among 79.4% and 45.0% students, respectively; low personal accomplishment was reported by 50.5% students. Female students reported higher levels of emotional exhaustion compared to males (p = 0.012). A low score on personal achievement scale of MBI was least frequent among the freshmen and most frequent among sophomores (41.1% and 65.3%, respectively; p = 0.986). There were more students with burnout who considered their health as a worsened vs. pre-study period compared to students with no burnout, both concerning mental (61.4% vs. 38.6%) and physical health (61.1% vs. 38.9%; both p<0.001). There were more smokers among students who suffered from burnout compared to students who did not (52.0% vs. 48.0%; p = 0.013). A multiple regression revealed an independent dose-response effect of perceived stress at exams on the onset of burnout (moderate stress OR = 2.164 and high stress OR = 3.878). Also, students with the moderate and high stressful effect of communication with teaching staff, as well as, those with worse self-perceived physical and mental health had more than two times higher presence of burnout. CONCLUSIONS: The prevalence of burnout among Belgrade veterinary students is relatively high. Primary prevention should be focused on the revealed predictors of burnout.

Status of cardiovascular health in the Republic of Serbia: Results from the National Health Survey.

BACKGROUND: Cardiovascular diseases (CVD) remain the most significant cause of death in low- and middle-income countries where the burden of CVD continues to rise due to the increasing incidence of CVD. The aim of this study was to assess the prevalence of ideal cardiovascular health (CVH) across sex and age groups and to analyze associations between demographic and socio-economic variables and ideal CVH metrics in the adult population of the Republic of Serbia. METHODS: Information on demographic (age, sex, marital status, and type of settlement) and socio-economic characteristics (education, and wealth index), and the 7 ideal CVH metrics (smoking, physical activity, healthy diet, BMI, blood pressure, cholesterol, and glucose) was obtained for 13100 respondents aged 20 years and above, from the 2013 National Health Survey in the Republic of Serbia. According to the American Heart Association, the ideal CVH was defined as the simultaneous presence of 7 ideal CVH metrics. RESULTS: Out of all ideal CVH metrics, the most prevalent components were ideal glucose (92.2%), ideal cholesterol (86.4%) and ideal smoking (63%), while the least prevalent ideal CVH component was ideal healthy diet (2.4%). Only 0.1% had all 7 CVH components at the ideal level. According to the multivariable logistic regression analysis the higher number of ideal CVH metrics was observed in women (OR = 4.46), younger people (OR = 7.12), people living without partner (OR = 1.70), more educated (OR = 2.51 for middle educated and OR = 3.57 for high educated), as well as among the rich (OR = 1.43). CONCLUSION: Our findings of existing age-specific, sex and socio-economic differences in the prevalence and number of ideal CVH metrics should serve for the development of appropriate CVD prevention policies tailored to fit specific needs of both sexes, all age groups and people with different socioeconomic status.

Relationship between socioeconomic and nutritional status in the Serbian adult population: a cross-sectional study

ABSTRACT BACKGROUND: Socioeconomic status is a well-known risk factor for obesity. The aim of this study was to assess the relationship between socioeconomic and nutritional status in the Serbian adult population. DESIGN AND SETTING: Cross-sectional study on data from the 2013 National Health Survey performed in Serbia. METHODS: The study population consisted of adults aged ≥ 20 years. Face-to-face interviews and anthropometric measurements were conducted by trained staff. Associations between body mass index and sociodemographic variables were analyzed using multivariable logistic regression analyses. RESULTS: Out of 12,461 subjects of both sexes, 36.4% were overweight and 22.4% were obese. The prevalences of overweight and obesity differed significantly between the sexes, regarding all sociodemographic characteristics. Among women, educational attainment was associated with lower risk of being overweight (odds ratio, OR = 0.82; 95% confidence interval, CI: 0.69-0.98 for medium-level and OR = 0.77; CI: 0.62-0.97 for higher education) or obese (OR = 0.68; CI: 0.57-0.82 for medium-level and OR = 0.41; CI: 0.31-0.54 for higher education). In contrast, medium-level (OR = 1.28; CI: 1.08-1.52) and highly educated men (OR = 1.39; CI: 1.11-1.74) were more frequently overweight than were those with low education. Among men, grade I obesity was positively related to the richest wealth index group (OR = 1.27), while the opposite was true for grade II obesity among women (OR = 0.61). CONCLUSION: This study showed significant socioeconomic inequalities in nutritional status between men and women. Continuous monitoring of socioeconomic patterns relating to weight is important, especially with further exploration of the link between education and obesity.

Associations between racial discrimination, smoking during pregnancy and low birthweight among Roma.

Background: Racial discrimination may increase the risk of low birthweight (LBW), but has not been studied among Roma, the largest minority population in Europe. Moreover, few studies test both institutional and interpersonal forms of racial discrimination on health. Our objective was to examine associations between institutional and interpersonal racial discrimination with LBW, and to test potential mediation by smoking during pregnancy. In 2012-2013, Romani women interviewers surveyed 410 Romani women in Serbia and Macedonia. We measured institutional discrimination (neighborhood segregation, legal status of housing and neighborhood socioeconomic status), interpersonal discrimination [Everyday Discrimination Scale (EDS)], birthweight and smoking by self-report or interviewer report. We estimated relative risks for discrimination on LBW and separately on smoking during pregnancy using log-binomial regression, adjusting for age, parity, years at residence and wealth. The indirect effect of high EDS via smoking on LBW was estimated using inverse odds weighting mediation. Living in a low SES neighborhood showed a 2-fold risk of LBW [adjusted risk ratio (aRR) = 2.4, 95% CI = 1.2, 5.0]; aRRs for segregation and illegal housing were weaker (aRR = 1.8, 95% CI = 0.7, 4.3; aRR = 1.3, 95% CI = 0.6, 2.6, respectively). Institutional measures were not associated with smoking. High EDS was associated with LBW (aRR = 2.4, 95% CI = 1.1, 5.2) and smoking during pregnancy (aRR = 1.4, 95% CI = 1.1, 1.8); the indirect effect of EDS on LBW via smoking was not significant. Interpersonal discrimination and living in a low SES neighborhood were associated with LBW among Roma. Interventions to improve Romani health may benefit from a human rights approach.

Predictors of prenatal smoking and attempted smoking cessation during pregnancy: a community-based study of Romani women in Southeastern Europe.

Background: The objective of this study was to examine predictors of prenatal smoking, and attempted smoking cessation during pregnancy among Romani women. Methods: A community-based, cross-sectional study (November 2012 to February 2013) of 410 Romani women in Roma settlements in Serbia and Macedonia was conducted. Logistic regression was used to identify predictors of prenatal smoking and attempted smoking cessation during pregnancy. Results: Romani women older than 30 years and those who were living with a man were over twice as likely (adjusted odds ratio (aOR) 2.48, 95% confidence interval (CI) 1.12-5.46; aOR 2.09, 95% CI 1.27-3.43) to smoke during pregnancy, compared to women <20 and married women, respectively. An inverse relationship between education and prenatal smoking was observed (for primary education versus no education, aOR 0.56, 95% CI 0.32-0.98; for secondary or higher education versus no education, aOR 0.38, 95% CI 0.16-0.90). Having a husband/partner who smokes was associated with significantly increased likelihood of prenatal smoking (aOR 3.71, 95% CI 2.20-6.25) and decreased likelihood of attempting to quit (aOR 0.51, 95% CI 0.24-1.06). Conclusions: Culturally sensitive and comprehensive prevention strategies and intervention programs are needed to reduce smoking during pregnancy among Romani women, including interventions targeting male partners.

Sex inequalities in cardiovascular health: a cross-sectional study.

BACKGROUND: The aim of this study was to determine sex differences in the prevalence of cardiovascular health (CVH) metrics according to the CVH status. METHODS: The cross-sectional, population-based study involved 2250 women and 1920 men aged ≥18 years that participated in the 2010 National Health Survey in the Republic of Srpska, Bosnia and Herzegovina. Prevalence of CVH behaviours (smoking, body mass index, physical activity, diet), CVH factors (cholesterol, fasting blood glucose and blood pressure, plus smoking) and ideal CVH were estimated according to the American Heart Association criteria for ideal, intermediate and poor levels. Association between sex and ideal CVH categories was analyzed with multivariable logistic regression analysis across three age stratums. RESULTS: A higher prevalence of ideal CVH metrics was seen in women for smoking status, body mass index, healthy diet score and blood pressure, and in men for physical activity and total cholesterol. Women from all age groups had better CVH behaviours (odds ratio [OR] = 1.40 for the youngest; OR = 2.05 for middle-aged; and OR = 2.03 for older-aged women), while only women from the youngest age group had better CVH factors (OR = 5.09). In line with this, ideal overall CVH prevailed in younger and middle-aged women in comparison to men of the same ages (OR = 3.01 and OR = 2.25, respectively), while disappeared in older ones. CONCLUSIONS: Significant differences in the prevalence of CVH metrics between men and women in the Republic of Srpska should be considered in cardiovascular disease prevention.

Socio-Economic Differences in Cardiovascular Health: Findings from a Cross-Sectional Study in a Middle-Income Country.

BACKGROUND: A relatively consistent body of literature, mainly from high-income countries, supports an inverse association between socio-economic status (SES) and risk of cardiovascular disease (CVD). Data from low- and middle-income countries are scarce. This study explores SES differences in cardiovascular health (CVH) in the Republic of Srpska (RS), Bosnia and Herzegovina, a middle-income country. METHODS: We collected information on SES (education, employment status and household's relative economic status, i.e. household wealth) and the 7 ideal CVH components (smoking status, body mass index, physical activity, diet, blood pressure, total cholesterol, and fasting blood glucose) among 3601 participants 25 years of age and older, from the 2010 National Health Survey in the RS. Based on the sum of all 7 CVH components an overall CVH score (CVHS) was calculated ranging from 0 (all CVH components at poor levels) to 14 (all CVH components at ideal levels). To assess the differences between groups the chi-square test, t-test and ANOVA were used where appropriate. The association between SES and CVHS was analysed with multivariate linear regression analyses. The dependent variable was CVHS, while independent variables were educational level, employment status and wealth index. RESULTS: According to multiple linear regression analysis CVHS was independently associated with education attainment and employment status. Participants with higher educational attainment and those economically active had higher CVHS (b = 0.57; CI = 0.29-0.85 and b = 0.27; CI = 0.10-0.44 respectively) after adjustment for sex, age group, type of settlement, and marital status. We failed to find any statistically significant difference between the wealth index and CVHS. CONCLUSION: This study presents the novel information, since CVHS generated from the individual CVH components was not compared by socio-economic status till now. Our finding that the higher overall CVHS was independently associated with a higher education attainment and those economically active supports the importance of reducing socio-economic inequalities in CVH in RS.

The prevalence of pseudoexfoliation syndrome and possible systemic associations in patients scheduled for cataract surgery at the Military Medical Academy in Belgrade.

BACKGROUND/AIM: Pseudoexfoliation syndrome (PEX) is an age-related systemic degenerative disorder characterized by the production and progressive accumulation of extracellular fibrillar eosinophilic material in the anterior segment of the eye. The aim of the study was to evaluate several clinical aspects of PEX, such as frequency of PEX and pseudoexfoliation glaucoma (PEXG), intraocular pressure (IOP), the type of lens opacity, and the possible relationship of PEX and systemic diseases. METHODS: All 674 cataract patients had a comprehensive eye examination, including slitlamp biomicroscopy before and after mydriasis, IOP measurement, and fundus examination. The patients were classified into two groups: the PEX and the non-PEX group. RESULTS: The overall prevalence of PEX syndrome was found to be 17.5% (118 patients). The mean age of PEX patients (79.7 +/- 6.1 years) was significantly higher when compared with those without PEX (73.5 +/- 9.1 years) (p = 0.000). The prevalence of PEX syndrome was found to increase with age, from 7.3% in the 7th decade of life to 27% in patients older than 80 years (p < 0.001). The most common cataract type in the PEX patients was mature cataract observed in 40.7% of patients. The rest of the patients had mixed (30.5%), nuclear (25.4%), cortical (1.7%) and hypermature cataract (1.7%). Among the PEX patients 44 (37.2%) had glaucoma. Intraocular pressure was significantly higher in eyes with pseudoexfoliations than in eyes without it (17.8 +/- 3.2 mmHg and 15.8 +/- 2.8 mmHg, respectively; p = 0.001). Moreover, the prevalence of coronary heart disease was found to be higher in PEX patients. CONCLUSION: PEX syndrome is a common problem among Serbian patients scheduled for cataract surgery. It represents one of the major glaucoma risk factors and probably associated with ischemic heart disease, intraoperative and postoperative problems in cataract surgery.

Status of cardiovascular health in a transition European country: findings from a population-based cross-sectional study.

OBJECTIVES: Our aim was to assess the prevalence of ideal cardiovascular health (CVH) in the adult population of Republic of Srpska (RS), Bosnia and Herzegovina, and its relationship with socio-demographic characteristics of participants. METHODS: We included 4,170 adults (mean age 50.2 years; 54 % women) from the National Health Survey performed from September to November 2010 in RS. Population prevalence of CVH health metrics (smoking, body mass index, physical activity, diet, cholesterol, blood pressure, and glucose) were estimated according to the American Heart Association criteria for "ideal", "intermediate", and "poor" levels. RESULTS: Only 0.02 % participants had ideal (all 7 health metrics at ideal levels), 7.6 % intermediate, and 92.4 % poor (at least one metric at poor level) CVH. The fasting glucose was the most prevalent (75.9 %), whereas the healthy diet was the least prevalent (4.4 %) ideal CVH metric. CONCLUSIONS: Our study indicates extremely low prevalence of ideal and high prevalence of poor CVH in the adult RS population. Such alarming results require urgent action. Comprehensive public health strategies and interventions must be developed to assist individuals and population in improving their CVH.

Risk behaviors for getting HIV infection among university students in Serbia.

The objective of this study was to determine risk-taking behaviors forgetting HIV infection among university students in Serbia. The study is based on a cross-sectional survey. Five hundred forty four undergraduate, first year students from two Belgrade universities were selected through random sampling, to answer a self-administrated anonymous questionnaire. Data were collected from 252 students from the Faculties of Medical Sciences, University of Belgrade (FMS) and 292 students from the Faculties of Arts, University of Arts Belgrade (FA). The differences between two groups of students and between students with risk and non-risk behavior were assessed by the chi2 and t-test. Besides that, multivariate techniques such as factor analysis and multivariate logistic regression were used in statistical analysis. Smoking (Odds Radio - OR = 5.05, 95% Confidence Interval - CI = 3.10-8.24), studying FA, (OR = 4.17, 95% CI = 2.69-6.46), male sex (OR = 3.85, 95% CI = 2.38-6.25), committing offences (OR = 1.51, 95% CI = 1.09-2.08) and older age (OR = 1.31, 95% CI = 1.10-1.55) were the most significant factors connected with the risk-taking behaviors for HIV transmission among the students. In conclusion, HIV prevention efforts must be sustained and designed to reach young people and to prevent patterns of risky behaviors before they start.

Association of socioeconomic status measured by education, and cardiovascular health: a population-based cross-sectional study.

OBJECTIVE: Cardiovascular health (CVH) is a relatively new concept defined by the American Heart Association (AHA). The aim of the present study was to assess whether the indices of CVH were discriminators of socioeconomic status (SES) in the adult population of the Republic of Srpska (RS). DESIGN: Population-based cross-sectional study. SETTING: RS, Bosnia and Herzegovina. PARTICIPANTS: The study involved 4165 adults aged ≥18 years (mean age 50.2; 54% women) who participated in the National Health Survey performed from September to November 2010 in the RS. STUDY VARIABLES: Participant's education was a proxy for SES. Potential discriminators of SES were indices of CVH presented according to AHA as: ideal health behaviours index (non-smoking, body mass index <25 kg/m(2), physical activity at goal level and healthy diet); ideal health factors index (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, untreated fasting glucose <100 mg/dL and non-smoking); and ideal CVH status (defined as all seven ideal health metrics present) versus intermediate and poor CVH status. RESULTS: Participants with high educational levels had a significantly greater number of ideal CVH metrics, and ideal health factor metrics compared with those with low or medium educational level (OR 0.88 95% CI 0.77 to 0.99 and OR 0.88 95% CI 0.80 to 0.96; OR 0.81 95% CI 0.69 to 0.96 and OR 0.77 95% CI 0.68 to 0.87; respectively). The number of ideal behaviour metrics was not a discriminator of educational groups. Concerning the categories of CVH status the poor CVH was a discriminator for low and medium education compared with those with high education (OR 1.93 95% CI 1.24 to 3.01 and OR 1.54 95% CI 1.08 to 2.19, respectively). CONCLUSIONS: Our findings emphasise the large potential for preventing cardiovascular disease, showing a low proportion with a favourable CVH profile, especially among low-educated people. It is necessary to consider prevention strategies aimed at improving CVH in RS, targeting primarily low educational groups.

The Children's Dermatology Life Quality Index (CDLQI): linguistic and cultural validation in Serbian.

BACKGROUND: The Children's Dermatology Life Quality Index (CDLQI) evaluates the impact of skin diseases on the patient's quality of life. OBJECTIVE: The purpose of the study was to translate and to validate the CDLQI into Serbian. METHODS: The CDLQI was translated into Serbian following international recommendations for translation and cultural adaptation. The validation study was carried out on a large cohort of secondary schoolchildren who self-reported acne. RESULTS: Translating the CDLQI consisted of forward translation, reconciliation, back translation, back-translation review, and cognitive debriefing. The good internal consistency of the scale was demonstrated with a Cronbach alpha coefficient of 0.87. A Spearman correlation coefficient of 0.66 between the CDLQI and the Cardiff Acne Disability Index (CADI) was deemed satisfactory to demonstrate concurrent validity. CONCLUSION: The translation, cross-cultural adaptation, and psychometric qualities of the CDLQI were satisfactory, enabling its application in clinical practice and future studies.

Socioeconomic inequalities, health damaging behavior, and self-perceived health in Serbia: a cross-sectional study.

AIM: To analyze the association of socioeconomic factors with self-perceived health in Serbia and examine whether this association can be partly explained by health behavior variables. METHODS: We used data from the 2007 Living Standards Measurement Study for Serbia. A representative sample of 13831 persons aged ≥20 years was interviewed. The associations between demographic factors (age, sex, marital status, and type of settlement), socioeconomic factors (education, employment status, and household consumption tertiles), and health behavior variables (smoking, alcohol consumption) and self-perceived health were examined using logistic regression analyses. RESULTS: A stepwise gradient was found between education and self-perceived health for the total sample, men, and women. Compared to people with high education, people with low education had a 4.5 times higher chance of assessing their health as poor. Unemployed (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.29-2.10), inactive (OR, 2.82; 95% CI, 2.49-3.19), and the most deprived respondents (OR, 1.17; 95% CI, 1.02-1.34) were more likely to report poor self-perceived health than employed persons and the most affluent group. After adjustment for demographic and health behavior variables, the magnitudes of all associations decreased but remained clearly and significantly graded. CONCLUSIONS: This study revealed inequalities in self-perceived health by socioeconomic position, in particular educational and employment status. The reduction of such inequalities through wisely tailored interventions that benefit people's health should be a target of a national health policy in Serbia.

The rising incidence and mortality of prostate cancer in Belgrade population.

The purpose of this study was to analyze the epidemiological situation of prostate cancer in Belgrade population. Morbidity data were obtained from the Institute of Public Health of Serbia for the period 1999-2005. Mortality data for the period 1990-2006, were derived from the Statistical Office of Republic of Serbia. Average standardized incidence and mortality rates for the prostate cancer were 33.57 and 11.86 respectively. Standardized incidence rates of prostate cancer steadily increased from 29.34 per 100,000 in 1999 to 36.86 per 100,000 in 2005. In the observed period, the mortality rates significantly increased in the age groups 50-59 (y = 2.77+0.42x, p = 0.015), 70-79 (y = 61.92+10.70x, p = 0.000) and 80+ (y = 183.08+19.99x, p = 0.000). The average annual percentage of changes (AAPC) was the highest (7.2%) for the 70-79 age group, the lowest (0.1%) for the youngest group (< or = 50), and 5% for the total. The increase of prostate cancer incidence and mortality during the observed period in Belgrade population indicate urgent need for Serbian health professionals to adopt existing evidence-based cancer control and preventive measures. A national policy including prostate specific antigen (PSA) screening should be considered.

Health-related quality of life in patients with psoriasis.

BACKGROUND: Psoriasis is a chronic skin disease that has a significant impact on patients' lives. OBJECTIVE: The purpose of the study was to assess factors that might influence the health-related quality of life (HRQoL) of patients with psoriasis. METHODS: We conducted a cross-sectional study of 110 outpatients with psoriasis. To assess the HRQoL, The Short Form 36 Health Survey (SF-36) and Skindex-29 were administered. Stressful life events during the last 12 months were assessed with Paykel's Interview for Recent Life Events. RESULTS: HRQoL was significantly more impaired in older patients, those with age at onset of 40 years or more, who had a positive family history and who experienced stressful life events in the 12 months preceding the interview. Sex and clinical severity were not significantly related to patients' HRQoL. CONCLUSION: Psoriasis patients have poorer HRQoL than the general population. This study supports the decision to use both generic and skin-specific instruments to assess the impact of psoriasis on HRQoL.

[Oesophageal-cancer-derived death in the population of Belgrade in a period 1989-2006].

BACKGROUND/AIM: Oesophageal cancer is the sixth most common cause of death from all malignant tumors in the world (fifth in men, eighth in women). This cancer was estimated to account for about 529 000 new cases and about 442 000 deaths in the year 2007. In the year 2002 the highest standardized mortality rates (per 100 000 habitants) of oesophageal carcinoma were noticed in the East Asia (men/women: 18.8/7.7) and East Africa (18.6/7.8), while the lowest were noticed in the Middle Africa (1.4/0.2) and West Africa (1.3/0.5). The aim of this descriptive epidemiologic study was to analyze epidemiologic situation of oesophageal cancer in Belgrade population during the period 1989-2006, using mortality data. METHODS: Mortality data were collected from the City Organization for Statistics. In data analysis we used mortality rates which were standardized directly using those of the world population as the standard, and proportions. A denominator for mortality rates was calculated using the Belgrade population which was an average of the two latest register years (1991 and 2002). In order to analyze trend mortality from oesophageal cancer we used linear trend. RESULTS: In Belgrade deaths from oesophageal cancer accounted for about 5.2% of all malignant tumors of intestinal system in male population, and 2.4% in female population. This cancer is, according to standardized mortality rates (per 100 000 habitants), on the fifth place in Belgrade population behind colorectal, stomach, pancreatic, liver and cholecystic cancer. During the period 1989-2006 in Belgrade 44 persons died from oesophageal carcinoma on the average each year, mainly men (75%), and the rest were women (25%). In male population during the same period we noticed a significant increase in trend mortality (y = 1.61 + 0.06x, p = 0.001), while in female population the increase of mortality was not significant. The male/female oesophageal cancer mortality ratio was 3:1. Mortality rates for oesophageal cancer rise with age in both sexes and they are highest in the age group of 70 and more years. Significant increase in mortality from oesophageal cancer was noticed in age groups 20-29 and over 70 in male population, and age group 40-49 in female population. CONCLUSION: Increasing trend in oesophageal mortality suggests the necessity for improving measures of primary prevention including education about risk factors for this carcinoma (smoking, alcohol consumption, hot food and drinks), early diagnosis, and treatment.

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 Paykel's 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.

[Impact of some constitutional characteristics on the development of basal cell carcinoma].

BACKGROUND/AIM: Basal cell carcinoma (BCC) is the most common form of skin cancer in the white population. Increasing incidence of BCC imposes the requirement to indentify the risk factors due to eventual preventive action. The aim of this study was to assess the role of some constitutional characteristics in development of BCC among the Montenegrian population. METHODS: A case-control study was conducted at the Dermatology Department of Clinical Center of Montenegro in Podgorica from 2002-2003. The study group included 100 histopatologically confirmed BCC cases, while the control group consisted of 100 patients from the same department, who did not present skin cancer and who were individually matched to the cases by sex and age (+/-5 years). All participants were interviewed using an epidemiological questionnaire. For statistical analysis t test and McNemar chi2 test for matched pairs and multivariate logistic regression analyses were used. RESULTS: The risk for development of BCC was increased among the persons with lighter hair color (t = 4.63; df = 99; p < 0.001), fair skin (t = 2.37; df = 99; p = 0.020), lighter eyes color (t = 2.86; df = 99; p = 0.005), with nevuses (OR = 13.13; p = 0.025; 95% IP = 1.39-12.03), and among those whose skin tone after sun exposure remained light (OR = 3.14; p = 0.001; 95%IP = 1.59-6.18). CONCLUSION: Our study confirmed the significance of constitutional characteristics such as lighter hair color, fair skin, lighter eyes color, and the presence of nevuses in the development of BCC.