Comparison of Demographic, Epidemiological, Immunological, and Clinical Characteristics of Patients with HIV Mono-infection Versus Patients Co-infected with HCV or/and HBV: A Serbian Cohort Study.

OBJECTIVE: The study aimed to correlate the status of hepatitis C (HCV) and hepatitis B virus (HBV) co-infection in patients with human immunodeficiency virus (HIV) infection with clinical and demographic data prior to starting highly active antiretroviral therapy (HAART) and assess the impact of HCV and HBV co-infection on the natural history of HIV infection. PATIENTS AND METHODS: The study involved a total of 836 treatment-naive patients with available serological status for HBV and HCV at the point of therapy initiation. Patients were stratified into four groups: HIV mono-infection, HIV/HCV, HIV/HBV, and HIV/HCV/HBV co-infection. Demographic, epidemiological, immunological and clinical characteristics were analyzed in order to assess the possible impact of HCV and HBV co-infection on HIV - related immunodeficiency and progression to AIDS. RESULTS: The prevalence of HCV and HBV co-infection in our cohort was 25.7% and 6.3%, respectively. Triple HIV/HCV/HBV infection was recorded in 1.7% of the patients. In comparison with those co-infected with HCV, patients with HIV mono-infection had lower levels of serum liver enzymes activity and higher CD4 cell counts, and were less likely to have CD4 cell counts below100 cells/µL and clinical AIDS, with OR 0.556 and 0.561, respectively. No difference in the development of advanced immunodeficiency and/or AIDS was recorded between patients with HIV monoinfection and those co-infected with HBV, or both HCV/HBV. CONCLUSION: HIV/HCV co-infection was found to be more prevalent than HIV/HBV co-infection in a Serbian cohort. Co-infection with HCV was related to more profound immunodeficiency prior to therapy initiation, reflecting a possible unfavorable impact of HCV on the natural history of HIV infection.

Prognostic Significance of Atrial Fibrillation in Lower Limb Amputee Patients.

OBJECTIVE: In patients with risk factors or established atherothrombosis, atrial fibrillation (AF) is associated with a poor prognosis compared with patients without AF. The aim of this study was to evaluate the prevalence of AF in patients with lower limb amputation (LLA) and its association with cardiovascular death and adverse cardiovascular events in long-term follow-up. METHODS: Observational prospective study of consecutive patients after index major (transfemoral and transtibial) LLA. The primary endpoint was cardiovascular death and secondary endpoint was a composite of adverse cardiovascular events at follow-up (acute myocardial infarction, contralateral lower limb amputation, and ischaemic stroke). RESULTS: Of 282 patients with LLA, 46 (16.3%) patients had AF. AF patients were significantly older compared with patients without AF (median 74.0, IQR 13.0 vs. median 67.0, IQR 14.8 years, p < .001). Diabetes and smoking on the other hand were significantly less prevalent in patients with AF compared with those without AF (41.3% vs. 72.0%, p < .001 and 56.5% vs. 76.3%, p = .01, respectively). 54.3% of patients with AF were on oral anticoagulation therapy. At a median follow-up of 24.0 months (IQR 19.0-32.0), 28.3% patients with AF died of cardiovascular causes versus 17.8% without AF (HRR 1.8, 95% CI 1.0-3.4, p = .06). Adverse cardiovascular events occurred in 32.6% of patients with AF during follow-up versus 22.0% without AF (HRR 1.9, 95% CI 1.0-3.3, p = .03). In multivariate Cox regression analysis, AF (HRR 2.3, 95% CI 1.3-4.2, p = .01) and diabetes (HRR 2.1, 95% CI 1.1-3.9, p = .02) were identified as independent predictors of adverse cardiovascular events during the follow-up. CONCLUSION: AF is common in patients with LLA and associated with higher risk of adverse cardiovascular events during long-term follow-up.

Relative risk for cardiovascular morbidity in hemodialysis patients regarding gene polymorphism for IL-10, IL-6, and TNF.

Uremia-related inflammation is prone to be a key factor to explain high cardiovascular morbidity in hemodialysis patients. Genetic susceptibility may be of importance, including IL-10, IL-6, and TNF. The aim was to analyze IL-10, IL-6, and TNF gene polymorphisms in a group of hemodialysis patients and to correlate the findings with cardiovascular morbidity. This study included 169 patients on regular hemodialysis at Zvezdara University Medical Center. Gene polymorphisms for IL-10, IL-6 and TNF were determined using PCR. These findings were correlated with the cardiovascular morbidity data from patient histories. Heterozygots for IL-10 gene showed significantly lower incidence of cardiovascular events (p = 0.05) and twice lower risk for development of myocardial infarction, but experienced twice higher risk for left ventricular hypertrophy. Regarding TNF gene polymorphism, patients with A allele had 1.5-fold higher risk for cerebrovascular accident and cardiovascular events and 2-fold higher risk for hypertension and peripheral vascular disease. Patients with G allele of IL-6 gene experienced 1.5-fold higher risks for cerebrovascular accident. We need studies with larger number of patients for definitive conclusion about the influence of gene polymorphisms on cardiovascular morbidity in hemodialysis patients and its importance in everyday clinical practice.

Association of body mass index and waist circumference with severity of knee osteoarthritis.

AIM: The aim of the present study was to investigate the association of the body mass index (BMI) and waist circumference (WC) with the severity of radiographic severity of knee osteoarthritis (rKOA) Methods. A cross-sectional study had been applied during the research which included 150 patients diagnosed at the General Hospital in Uzice and Health Center in Arilje (Serbia). The study included patients over the age of 50 diagnosed with OA according to The European League Against Rheumatism (EULAR) criteria. Data on social-demographic characteristics, health habits, and personal and family histories of the participants were collected through a specific questionnaire designated for this research. The severity of the disease was assessed pursuant to radiological changes using the Кellgren-Lawrence grading scale (K-L). The state of nourishment was assessed according to the BMI and WC. RESULTS: According to multivariate logistic regression analyses, after adjustment on age, sex, marital status, formal education, present occupation, smoking, alcohol consumption and physical activity, higher grades of rKOA (grade III and grade IV) were significantly related to BMI (p = 0.038) and WC (p < 0.001). The association was much stronger for obesity defined as BMI ≥30 kg/m2 (p = 0.002) and for abdominal obesity - WC > 102 cm in men and > 88 cm in women (p = 0.009). CONCLUSION: This study showed that obesity defined as BMI ≥30 kg/m2 and abdominal obesity are strongly related to K-L of rKOA, the associations being of very similar extent.

Association between body mass index and prevalence of multimorbidity: a cross-sectional study.

OBJECTIVES: To explore the prevalence of multimorbidity in Serbia according to sex and body mass index (BMI) categories, and to examine the association between BMI and multimorbidity. In addition, this study examined the relationships between the main demographic and socio-economic characteristics of the population (age, settlement, education) and multimorbidity. STUDY DESIGN: Secondary analysis of data from the 2013 Serbian National Health Survey. METHODS: This study analyzed data from 13,103 participants aged ≥20 years with BMI data. The associations between BMI, age, education and multimorbidity were analyzed by multivariate logistic regression. RESULTS: The overall prevalence of multimorbidity was higher than the overall prevalence of a single disease (26.9% vs 20.7%). The proportion of participants who reported two or more chronic diseases increased with each BMI category in both sexes, reaching the highest values in obese category III. Odds ratios (ORs) for the prevalence in all morbidity groups increased gradually with BMI category, and the highest OR values were found in obese category III. Males of obese category III were seven times more likely to have multimorbidity [OR 7.2, 95% confidence interval (CI) 4.2-12.6] than males of normal weight, whereas females of obese category III were nine and a half times more likely to have multimorbidity (OR 9.5, 95% CI 4.0-22.4) than females of normal weight. In the multivariable analysis, age (both sexes), low and middle level of education (males), and rural settlement and low level of education (females) were found to be predictors of multimorbidity. CONCLUSIONS: This study found positive associations between obesity and multimorbidity and between overweight and multimorbidity. Recognizing these associations is of great importance from both clinical and public health perspectives because this could lead to an integrated approach for patients.

Relationship Between Pain and CEAP C Categories of Chronic Venous Disease.

In this study, we investigated whether the occurrence and intensity of leg pain are related to C class of the clinical, etiological, anatomical, and pathophysiological (CEAP) classification for chronic venous disease (CVeD). This cross-sectional study, conducted in Serbia, included 2841 patients: 2027 (71.3%) women and 814 (28.7%) men with CVeD diagnosed by general practitioners. For the first time, the Numeric Rating Scale of 0 to 5 units was used to assess the intensity of pain. For the analysis, univariate and multivariate logistic and linear regressions were applied. Pain in the legs was reported by 90.5% of the patients. The occurrence of pain significantly (P < .001) increased with increasing C class. Of the patients who reported pain in the legs, 42.0% had moderate pain, 23.7% had moderate to severe pain, 22.8% had light pain, 11.2% had severe pain, and 0.3% had very severe pain. Severity of pain differed significantly (P < .001) according to C class. Light and moderate pain gradually decreased and severe pain gradually increased from C0 to C6 class. These associations remained significant after adjustment for age, body mass index, and family history of CVeD.

Quality of life in patients with alopecia areata: a hospital-based cross-sectional study.

BACKGROUND: Previous studies suggest that alopecia areata (AA) may significantly affect patient quality of life (QoL). There are no studies that assess QoL in Serbian AA patients. OBJECTIVES: This study aims to assess the impact of AA on patients' QoL in comparison to patients affected by other skin diseases and to determine the impact of sociodemographic and clinical characteristics of AA patients on QoL. METHODS: A hospital-based cross-sectional study of 60 patients with AA was conducted at the Clinic of Dermatovenereology, Clinical Center of Serbia, Belgrade between April 2012 and June 2013. The severity of hair loss was assessed using the Severity of Alopecia Tool (SALT). Patients' self-assessment of QoL was measured by three self-administered questionnaires: The Short Form-36 Health Survey (SF-36), Dermatology Life Quality Index (DLQI) and The Skindex-29. RESULTS: Sixty AA patients (16 males and 44 females) with mean age of 37.35 ± 14.26 years completed the questionnaires. We confirmed that QoL of our AA patients was impaired. Compared with patients suffering from psoriasis, atopic dermatitis and onychomycosis AA patients presented significantly better QoL. Severity of disease (SALT) correlated only with personal relationship - dimension of DLQI (ρ = 0.29, P < 0.05) and social functioning - dimension of Skindex (ρ = 0.26, P < 0.05). No correlation was observed between severity of the disease and SF-36 subscales. AA patients with depression had significantly worse QoL in daily activities, leisure, work or school and personal relationships - DLQI dimensions, and emotions and social functioning - Skindex subscales. CONCLUSION: Our study demonstrates that AA influences QoL, but to a lesser degree than observed for psoriasis, atopic dermatitis and onychomycosis.

Survival and prognostic factors of anaplastic thyroid carcinoma.

BACKGROUND: Anaplastic thyroid carcinoma (ATC) is relatively rare and represents one of the most aggressive tumours with poor prognosis, despite therapy. The aim of the study was to analyse demographic and clinical characteristics of ATC patients, and to identify survival rates and prognostic factors. METHODS: In a retrospective study (1995-2005) ATC was found in 150 patients treated at our institution. Survival was calculated by Kaplan-Meier curve and log-rank test. Potential prognostic factors affecting survival were compared by Cox univariate and multivariate analyses. RESULTS: Mean survival time was 56 weeks; median survival time was 16 weeks and 1 and 5-year survival were 17% and 8%. More than 10% died during the first month and 50% died up to the fourth month. Multivariate analysis showed that age, goitre and surgery were independent prognostic factors of survival in all ATC patients. Among operated patients, the extent of tumour resection, distant metastasis and multicentricity were independent prognostic risk factors of survival. Postoperative radiotherapy was a protective factor. CONCLUSIONS: There is still no successful treatment of ATC that can guarantee long term survival. Younger patients with pre-existing goitre, who undergo complete resection of unilocular early stage ATC without distant metastasis and with postoperative external radiotherapy, stand a better chance of long-term survival.

Survival and Prognostic Factors of Anaplastic Thyroid Carcinoma.

BACKGROUND: Anaplastic thyroid carcinoma (ATC) is relatively rare and represents one of the most aggressive tumours with poor prognosis, despite therapy. The aim of the study was to analyse demographic and clinical characteristics of ATC patients, and to identify survival rates and prognostic factors. METHODS: In a retrospective study (1995-2005) ATC was found in 150 patients treated at our institution. Survival was calculated by Kaplan-Meier curve and log-rank test. Potential prognostic factors affecting survival were compared by Cox univariate and multivariate analyses. RESULTS: Mean survival time was 56 weeks; median survival time was 16 weeks and 1 and 5-year survival were 17% and 8%. More than 10% died during the first month and 50% died up to the fourth month. Multivariate analysis showed that age, goitre and surgery were independent prognostic factors of survival in all ATC patients. Among operated patients, the extent of tumour resection, distant metastasis and multicentricity were independent prognostic risk factors of survival. Postoperative radiotherapy was a protective factor. CONCLUSIONS: There is still no successful treatment of ATC that can guarantee long term survival. Younger patients with pre-existing goitre, who undergo complete resection of unilocular early stage ATC without distant metastasis and with postoperative external radiotherapy, stand a better chance of long-term survival.

Long-term prognostic significance of living alone and other risk factors in patients with acute myocardial infarction.

BACKGROUND: Living alone has been associated with higher risk of acute coronary syndrome in general population, but there are no consistent findings about its effect on prognosis after acute myocardial infarction (AMI). AIM: To analyse the relationships between living alone and other risk factors at baseline and long-term survival after AMI. METHODS: One hundred and thirty-five patients with confirmed myocardial infarction (MI) admitted to the coronary care unit of the Institute of Cardiovascular Diseases, Clinical Centre of Serbia in Belgrade, between June 2002 and April 2006, were followed up until September 2011. Survival time was estimated using the Kaplan-Meier method and Cox regression analysis. RESULTS: Patients with MI were followed up for a median of 77 months. The mean age of participants was 57.82 years (SD ± 10.8), and one quarter of them were women. According to the multivariate Cox regression analysis stratified on marital status, the model in which were included living alone, age, gender, education, obesity, smoking, hyperlipidaemia, hypertension, diabetes mellitus, previous cardiovascular and other disease, thrombolytic therapy and localisation of MI, the following variables were found to be independent predictors of death after AMI: living alone, with a hazard ratio (HR) of 7.60 [95 % confidence interval (CI) 1.99-29.08], diabetes mellitus (HR 3.31; 95 % CI 1.33-8.23), current smoking (HR 2.82; 95 % CI 1.03-7.71) and, older age (HR 1.13; 95 % CI 1.06-1.19). CONCLUSION: The results of this study support hypothesis that patients who live alone have higher long-term all-cause mortality following AMI.

Risk factors for anaplastic thyroid cancer.

Background. Anaplastic thyroid cancer (ATC) is a form of thyroid cancer with very poor prognosis, but is fortunately quite rare. Its aetiology is unknown and not well researched. Aim. The aim of this study was to identify potential risk factors for ATC. Material and Method. Case-control study of 126 ATC patients (77 females and 49 males) and 252 controls individually matched by gender, age, and place of abode. In statistical analysis we used a Cox regression model. Results. Univariate logistic regression showed that the risk factors for ATC are low education level, type B blood group, goitre, other nonthyroid malignancies, diabetes, late menarche, and an early first pregnancy. Multivariate logistic regression analysis showed that independent risk factors for ATC are low education level (OR = 1.42, 95% CI = 1.09-1.86), type B blood group (OR = 2.41, 95% CI = 1.03-5.66), and goitre (OR = 25-33, 95% CI = 5.66-126.65). Conclusion. Independent risk factors for ATC are: low education level, type B blood group, and goitre.

First Report of Stolbur Phytoplasma Affecting Cichorium intybus in Serbia.

Chicory (Cichorium intybus, Asteraceae) is a typical Mediterranean plant indigenous to Europe, western Asia, Egypt, and North America (3). It is commonly consumed as a fresh vegetable in salads. In rural areas of Serbia it grows as a weed in crops, but it is used in folk medicine to treat skin disorders due to its antihepatotoxic activity (3). Methanol extracts of chicory leaves showed moderate antibacterial activity against enteric bacteria (3). A phytoplasma-like disease, expressed as proliferation of chicory shoots and flowers, was observed on wild plants for the first time in Obrenovac vicinity (44°40' N, 20°20' E) in July 2012. A flattening of the stem with a large number of filamentous leaves, contortion and abnormal growth of flowers on the stem (typical fasciation symptoms) were observed. Diseased plants did not produce seeds. Total DNA was extracted from the leaf midveins of 15 symptomatic and five symptomless plants (4). PCR amplification of 1.5-kb 16S rDNA fragment was performed using DreamTaq Green master mix (Thermo Scientific, Lithuania) and phytoplasma universal primer pairs P1/16S-Sr (1). Products of nested PCR (1.2 kb) were obtained using primer pair R16F2n/R2 (1). Both amplicons were detected in all diseased samples; however, DNA from symptomless samples yielded no amplicons. Restriction fragment length polymorphism (RFLP) analysis of R16F2n/R2 PCR products was performed in independent reactions using four endonucleases (AluI, TruI1, HhaI and HpaII). RFLP patterns from chicory samples were compared to those of Stolbur (STOL), Aster Yellows (AY), Flavescence Dorée-C (FD-C), Poinsettia Branch-Inducing (PoiBI), and Clover Yellow Edge (CYE) phytoplasmas (1). All RFLP profiles from the chicory samples were identical to STOL reference strain, indicating that diseased chicory was affected by a phytoplasma that belongs to 'Candidatus Phytoplasma solani' (16SrXII-A group). The 16S rDNA sequence of representative sample from symptomatic plant (Vp4) was deposited under accession number KF661322 in NCBI GenBank. It showed 100% identity to KF263684.1 from Iranian peach, JQ730742.1 from Serbian valerian, and JQ730750 from Serbian corn, all belonging to the 'Ca. P. solani' taxon. Puna chicory disease on C. intybus associated with a subgroup 16SrV-B of phytoplasma was detected in China (2). This is the first report of the Stolbur phytoplasma associated with fasciation of C. intybus in Serbia and worldwide. References: (1) I. M. Lee et al. Int. J. Syst. Evol. Microbiol. 56:1593, 2006. (2) Z. N. Li et al. Can. J. Plant Pathol. 34:34, 2012. (3) J. Petrovic et al. Fitoterapia 75:737, 2004. (4) J. P. Prince. Phytopathology 83:1130, 1993.

EMortality from cancer of the lung in Serbia.

PURPOSE: To estimate the death rates for lung cancer and their secular trends in the population of Serbia, excluding the autonomous province of Kosovo and Metohia, over the 1991-2009 period. METHODS: A descriptive epidemiological method was employed. Trend of the lung cancer mortality rates was estimated using joinpoint linear regression analysis. An average annual percentage of change (AAPC) was computed for trend using linear models assuming a Poisson distribution, and the corresponding 95% confidence interval (CI). RESULTS: The mortality rate from lung cancer in Serbia ranks as the highest in the world, and it has been increasing continuously from 1991 (AAPC = + 1.9; 95% CI=1.7-2.2). A significant increase in mortality was present in both the male population (AAPC = + 1.4; 95% CI=1.2-1.6), and the female population (AAPC = + 3.9; 95% CI=3.6-4.3). However, a significant decline in lung cancer mortality in men was seen in some age groups. In young men (35-39 and 40-44 years age groups), lung cancer death rates decreased continuously from 1991, by - 5.1% and - 2.6% per year, respectively. Among men in the 45-49 years age group, a marked increase of lung cancer mortality was observed from 1991 to 1998 (by + 6.5% per year), followed by significant decrease (- 1.9% per year). Among women, only in the youngest age group (35-39 years) a declining trend was present (- 0.6% per year), yet without significance. CONCLUSION: Lung cancer mortality rates in Serbia indicate the importance of consistent application of measures of primary and secondary prevention that have been proven effective in other countries.

Potential influence of tubular dysfunction on the difference between estimated and measured glomerular filtration rate after kidney transplantation.

PURPOSE: Because no consensus exists regarding the most accurate calculation to estimate glomerular filtration rate (GFR) based on serum creatinine concentrations (sCr) after kidney transplantation, this study sought to assess the potential role of tubular dysfunction on GFR estimates using various equations as well as the effect of pharmacologic blockades on tubular secretion of creatinine on creatinine clearance (ClCr). METHODS: Iohexol GFR (mGFR) was performed in 17 stable kidney transplant recipients(R) at >24 months post-transplantation. Their mean age was 48.3 ± 11.3 years. All R were treated with a calcineurin inhibitor (CNI). At the time of study we measured sCr, 24 hour-ClCr, cystatin C, 24-hour proteinuria, microalbuminuria, FE Na, alfa1-microglobulinuria (alfa1-MG), and CNI concentrations. To block tubular secretion of Cr, recipients were prescribed cimetidine (2400 mg) 2 days before the sCr measurement. Additionally, to exclude dietary influences on sCr, R did not eat meat for 2 days before testing. GFR was estimated using the Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI), Cockroft-Gault (C&G), and Cystatin C (Cyst C) GFR equations. Mean kidney graft function over the previous 6 months was used as the control. Pearson correlation was determined between the differences between mGFR and estimatedGFR: Iohexol minus MDRD, EPI, Cyst C or C&G GFR for paired estimates. The diagnostic accuracy of the eGFRs to detect an mGFR of 60 mL/min/1.73 m(2) was examined by receiver operating characteristic curves. RESULTS: Mean mGFR was 75.2 ± 35.8 mL/min/1.73 m(2). The sCr increased but the 24-hour ClCr, MDRD, EPI, and C&G decreased after vs before cimetidine. The difference was significant for sCr (F = 12.933; P = .002) and MDRD GFR (F = 15.750; P = .001). mGFR was not significantly higher than all pair values of eGFRs, and not significantly lower than 24-hour ClCr before and after cimetidine. However, in comparison to all eGFRs, ClCr after cimetidine most approached mGFR. A significant positive correlation was observed between alfa1-MG and the difference between mGFR and MDRD (before, r = .543 [P = .045]; after cimetidine, 0.568 [P = .034]), EPI (before, r = 0.516 [P = .050]; after cimetidine, r = 0.562 [P = .036]), and ClCr (r = 0.633; P = .016), C&G (P = .581; P = .029) before cimetidine. Accuracy of eGFRs to detect mGFR of 60 mL/min/1.73 m(2) showed EPI GFR before cimetidine to show diagnostic accuracy for patients with GFR >60 mL/min/1.73 m(2) with a sensitivity of 81.8% and a specificity of 71.4%. CONCLUSIONS: Because mGFR is unavailable in many transplant centers, determination of ClCr after cimetidine may help to achieve a more accurate diagnosis of CKD among transplant patients.

Body mass index and primary chronic venous disease--a cross-sectional study.

OBJECTIVES: This study aims to investigate whether overweight and obesity are related to the clinical (C) category of clinical, etiologic, anatomic and pathophysiologic (CEAP) classification of chronic venous disease (CVD). DESIGN: A cross-sectional study. MATERIALS AND METHODS: The study was conducted in Serbia, in the year 2011. Men and women aged >18 years, consecutively coming to venous specialists because of venous problems in the legs, were included in the study. Patients demographic, anthropometric and clinical data were collected. For the analysis, univariate and multivariate logistic regressions were used. RESULTS: The study comprised 1116 subjects with primary CVD, 384 (34.4%) men and 732 (65.6%) women. Among them 464 (41.6%) were normal-weight patients (body mass index (BMI) < 25.0 kg m(-2)), 476 (42.7%) were overweight (BMI = 25.0-29.9 kg m(-2)) and 176 (15.8%) were obese (BMI ≥ 30.0 kg m(-2)). According to multivariate analysis, the CEAP C category of CVD was significantly more advanced in overweight and obese patients, the association being more pronounced in obese. Compared groups did not differ in the presence of venous reflux. In univariate analysis, venous obstruction was related to overweight and obesity but this association did not substantially affect the relationship between obesity and CEAP C categories of CVD. CONCLUSION: The CEAP C categories of CVD were significantly related to overweight and obesity, and this association was independent of age, sex and some other postulated risk factors.

The Brief Repeatable Battery: psychometrics and normative values with age, education and gender corrections in a Serbian population.

Cognitive impairment is present in up to 65 % of multiple sclerosis (MS) patients. The Brief Repeatable Battery of neuropsychological tests (BRB) is one of the most used neuropsychological tools for cognitive assessment in MS. However, relative lack of normative data limits its application in research and clinical practice. In order to obtain normative data for a Serbian population, we administered the BRB version A to 140 healthy subjects and assessed the influence of demographic factors such as gender, age, and education on the tests' scores. We also calculated corrections for these factors. Higher education was associated with better performance on all the tests. Age influenced all the tests, except the word list generation, higher age being associated with worse performance on all other tests. Women performed worse on the paced auditory serial addition test 2, no other gender differences were observed. Our data obtained for the Serbian population could further improve use of the BRB in clinical practice and for the research purposes, establishing cognitive evaluation as a part of standard neurological examination of MS patients.

Risk factors for chronic venous disease.

OBJECTIVE: Chronic venous disease (CVD) is a common problem in developing and developed countries. METHODS: A cross-sectional study, conducted in two major towns in Serbia, comprised 3225 subjects over 18 years old, enrolled in the survey consecutively by general practitioners (GPs) within their normal framework. Diagnosis of CVD was made by GPs on the basis of symptoms and visual examination. Data on potential risk factors were collected by the use of a questionnaire. RESULTS: The prevalence of CVD was significantly higher in women (73.7%) than in men (70.1%), although severe forms of CVD were significantly more frequent in men. Risk factors for CVD were age, body mass index ≥ 25.00 kg/m(2), family history of CVD, history of blood clots in veins and ever-smoking in both sexes, and menopause, increased number of child births and physical inactivity in women. CONCLUSION: The results obtained suggest the possibility of CVD prevention by modification of some behavioural risk factors.

Gender differences in smoking experience and cessation: do wealth and education matter equally for women and men in Serbia?

BACKGROUND: Although nowadays smoking is less popular, one-third of adults in Serbia still smoke regularly. The aim of this study was to analyze associations of smoking experience and quitting with gender and socio-economic status. METHODS: Cross-sectional, population-based nationally representative household survey (Health Survey, 2006). Age- and multivariate-adjusted logistic regression analyses were used to analyze predictors of smoking experience and cessation. RESULTS: Of 12 365 interviewed, 51.1% used to smoke: current smokers accounted for 36.8% and former smokers for 14.3%. Higher educated women were more prone to smoking [secondary school: odds ratio (OR), 1.75; 95% confidence interval (CI), 1.52-2.01; university degree: OR, 1.53; 95% CI, 1.26-1.86], whereas for men the opposite was observed (university degree: OR, 0.72; 95% CI, 0.60-0.86). Education also was 'pro-quitting' factor (university degree: OR, 1.46; 95% CI, 1.07-1.99 for women; university degree: OR, 1.61; 95% CI, 1.23-1.80 for men). To quit smoking, wealth status was gradually more important for women, while just the richest men were more likely to quit smoking (OR, 1.45; 95% CI, 1.09-1.93). CONCLUSION: The poorest women in Serbia and the least educated men are those least likely to quit smoking, which indicates that ability to quit is predicted by socio-economic status.

Risk factors for genital lichen sclerosus in men.

BACKGROUND: Lichen sclerosus (LS) is an inflammatory disease of the skin and mucous membranes. Its aetiology is still unknown. OBJECTIVES: To determine risk factors for genital LS in men. METHODS: In a case-control study, 73 patients with LS, consecutively diagnosed at the City Dispensary for Skin and Venereal Diseases in Belgrade, were compared with 219 male patients visiting the same institution because of tinea cruris. Univariate and multivariate logistic regression analyses were used for analysis of data collected. RESULTS: According to multivariate logistic regression analysis, risk factors for male LS were as follows: a personal history of genital injury [odds ratio (OR) 28·1, 95% confidence interval (CI) 5·2-150·8], vitiligo (OR 23·1, 95% CI 2·2-240·2), alopecia areata (OR 8·8, 95% CI 1·1-68·5) and hypercholesterolaemia (OR 3·1, 95% CI 1·1-8·2), and a family history of alopecia areata (OR 24·3, 95% CI 2·1-280·7), diseases of the thyroid gland (OR 9·1, 95% CI 2·3-36·2) and other autoimmune diseases (OR 8·6, 95% CI 1·3-58·6). CONCLUSIONS: The results of the present study are in line with the hypothesis that trauma of the penis is a possible trigger of symptoms in genetically predisposed individuals and that personal and family histories of autoimmune disorders are risk factors for male LS.