Joinpoint analysis of colorectal cancer trend in the Slovakia.

OBJECTIVES: The aim of this study is to describe the colorectal cancer trend in the Slovakia between 2002 and 2019. BACKGROUND: In 2020, the Slovakia ranked second among the 10 countries with the highest incidence of colorectal cancer and the highest number of deaths from colorectal cancer (hereafter also referred to as CRC). METHODS: To describe the situation of CRC, indicators of incidence and mortality rates stratified by age and sex for the available time period were chosen. A joinpoint regression software was used to identify changes in the trend of development. RESULTS: During the 18-year follow-up period (2002-2019), the overall trend in colorectal cancer incidence continued to increase with an overall mean annual change of 1.3 %. The incidence of CRC tended to increase from 50 years of age and increased with age. The most pronounced increasing trend was observed in the age group of 75 years and older (AAPC in men 1.9 %, IS +1.4; +2.5 and in women 2.0 %, IS +1.6; +2.4). CRC mortality remained relatively stable for the entire 18-year period. A decreasing trend in mortality was observed in the 25-49 age group with an overall annual percentage decrease of 0.9 % (IS -1.5; -0.3), while an increasing trend was observed in the 75+ age group with an overall annual percentage increase of 1.0 % (IS +0.8; +1.3). The incidence and mortality rates in men were higher than in women. CONCLUSION: The situation of colorectal cancer trend in the Slovakia has improved compared to the previous period (1971-2001) (Tab. 4, Fig. 4, Ref. 34).

Characteristics and outcome of severe traumatic brain injuries based on occupational status.

PURPOSE: The association of TBI with socioeconomic characteristics of patients has not been studied extensively. The objective of this study was to analyse the differences in injury characteristics and outcome in TBI patients based on their occupational status. METHODS: Data on patients from 13 centres based in Austria, Croatia, Slovakia, Bosnia and Herzegovina, and Macedonia were included in the analysis. Demographic characteristics, injury characteristics, treatment and outcome at various post-injury stages were compared according to occupational status. Logistic regression was used to adjust for the effect of co-variates. ICU mortality, hospital mortality, 6 months mortality, and outcome at 6 months were used as dependent variables. RESULTS: Overall, 886 patients were analysed with a mean age of 45.5 years. High-level falls were most prevalent in the blue-collar group (19%), most low-level falls occurred in the retired group. Traffic accidents were most common in students. The injuries were most severe in the blue-collar group and students. Highest mortalities and unfavourable outcomes were in the retired, students and white-collar workers had the best outcomes. Compared to retired patients, all groups had higher odds of favourable outcome at 6 months after adjusting for co-variates-OR from 2.2 (95% CI 1.1-4.6) for entrepreneurs to 3.6 (95% CI 1.8-7.2) for the blue-collar group. CONCLUSION: Our paper provides clues pertaining specifically to variations in patterns and outcomes of TBI according to occupational status which can inform prevention and planning of services and can serve to plan priorities for further research.

Explaining the decline in coronary heart disease mortality rates in the Slovak Republic between 1993-2008.

OBJECTIVE: Between the years 1993 and 2008, mortality rates from coronary heart disease (CHD) in the Slovak Republic have decreased by almost one quarter. However, this was a smaller decline than in neighbouring countries. The aim of this modelling study was therefore to quantify the contributions of risk factor changes and the use of evidence-based medical therapies to the CHD mortality decline between 1993 and 2008. METHODS: We identified, obtained and scrutinised the data required for the model. These data detailed trends in the major population cardiovascular risk factors (smoking, blood pressure, total cholesterol, diabetes prevalence, body mass index (BMI) and physical activity levels), and also the uptake of all standard CHD treatments. The main data sources were official statistics (National Health Information Centre and Statistical Office of the Slovak Republic) and national representative studies (AUDIT, SLOVAKS, SLOVASeZ, CINDI, EHES, EHIS). The previously validated IMPACT policy model was then used to combine and integrate these data with effect sizes from published meta-analyses quantifying the effectiveness of specific evidence-based treatments, and population-wide changes in cardiovascular risk factors. Results were expressed as deaths prevented or postponed (DPPs) attributable to risk factor changes or treatments. Uncertainties were explored using sensitivity analyses. RESULTS: Between 1993 and 2008 age-adjusted CHD mortality rates in the Slovak Republic (SR) decreased by 23% in men and 26% in women aged 25-74 years. This represented some 1820 fewer CHD deaths in 2008 than expected if mortality rates had not fallen. The IMPACT model explained 91% of this mortality decline. Approximately 50% of the decline was attributable to changes in acute phase and secondary prevention treatments, particularly acute and chronic treatments for heart failure (≈12%), acute coronary syndrome treatments (≈9%) and secondary prevention following AMI and revascularisation (≈8%). Changes in CHD risk factors explained approximately 41% of the total mortality decrease, mainly reflecting reductions in total serum cholesterol. However, other risk factors demonstrated adverse trends and thus generated approximately 740 additional deaths. CONCLUSION: Our analysis suggests that approximately half the CHD mortality fall recently observed in the SR may be attributable to the increased use of evidence-based treatments. However, the adverse trends observed in all the major cardiovascular risk factors (apart from total cholesterol) are deeply worrying. They highlight the need for more energetic population-wide prevention policies such as tobacco control, reducing salt and industrial trans fats content in processed food, clearer food labelling and regulated marketing of processed foods and sugary drinks.

Predictors of depression symptoms in patients with diabetes in Slovakia.

OBJECTIVE: The patterns of relationships between diabetes and depression in countries of central and eastern Europe (CEE) might differ from those in countries of western Europe and the United States. Among the reasons are specifics of transitioning healthcare systems (including mental health) and the general social, cultural, and economic background of these countries. The aim of this article is to analyze the prevalence of depression symptoms in patients with diabetes in Slovakia and to identify its predictors. METHOD: Diabetes patients (N= 1043) from two diabetes outpatient-care offices were recruited for the study. The Patient Health Questionnaire 9 (PHQ-9) was applied to screen for depression symptoms. Patients were categorized into four categories based on depression symptom severity. Demographic and disease-related factors were analyzed as predictors of depression symptoms. RESULTS: In the univariate analysis, a number of factors were associated with increasing severity of depression symptoms. In the multivariate analysis, lower education (OR 0.52; Cl 95% 0.33-0.81), and high degree of self-perceived severity of illness (OR 5.33; CI 95% 2.47-12.12) were confirmed as independent predictors of depression symptoms in our patients. CONCLUSIONS: Demographic and psychological factors have an important role in developing depression symptoms in patients with diabetes in our population. Further studies into the topic are needed to gain further clues on this topic throughout the Central European region. The findings of this study should be considered by mental health service providers and public health authorities to raise awareness about this important issue.

Relation of employment status, behavioral and social conditions on individual perception of health in a region of Slovakia: pilot study.

BACKGROUND: The question of the health status of the unemployed in the Slovak Republic is a relatively unexplored area of study, in spite of the fact that the country has experienced one of the most consistently high unemployment rates among the 27 states of the EU. The aim of the pilot study was to identify the health and the other impacts of unemployment on the population in the region of Zvolen. METHODS: two groups of respondents were studied: the long-term unemployed and a control group of the employed. The data was collected using the guided-interview questionnaire procedure. A total of 214 respondents were observed out of which 107 were from the long-term unemployed group and 107 from the control group. There were 83 male (38.8%) and 131 female respondents (61.2%). The average age of the group was 36.0 (CI 95% = 33.8-38.3). RESULTS: Using logistic regression, it was established that the chances of finding a job were 1.08 times greater in cases of a higher level of education (OR = 1.08, CI 95% = 1.04-1.12, P < or = 0,001). It was also established that smoking decreases the chances of finding employment by OR = 0.91 (CI 95% = 0.83-0.98) times (P < or = 0.01). People who are employed consume more alcohol attaining OR = 1.28 (CI 95% = 1.21-1.35) compared to the unemployed (P < or =0.0001). CONCLUSION: The study proved that even with restricted resources it is possible to obtain credible results comparable with those achieved by more complex studies.