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.

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.

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.

Refractive errors and binocular dysfunctions in a population of university students.

PURPOSE: This clinical study was performed to determine the presence of refractive errors and binocular dysfunctions in a population of university students. METHODS: Refraction and binocular function were evaluated in a young patient population (230 students and 234 nonstudent subjects, aged 18-27 years). Distance visual acuity (DVA) and near visual acuity (NVA), refraction, cover test (CT), ocular motility, near-point of convergence, horizontal phoria measurement by Maddox wing, negative and positive vergence amplitude in prism diopters, fusion amplitude in synoptophore, as well as stereoacuity (Titmus test) were tested. RESULTS: Emmetropia was the most frequent refractive status in our student and nonstudent groups (78.7%). Myopia was the most frequent refractive disorder in the whole population (13.1%). Myopia and hypermetropia were significantly more frequent in the students than in nonstudents (chi-square emp 47.55). Exophoria is significantly more frequent in myopic subjects. Vergence amplitude (t test 0.000) and fusion amplitude (t test 0.005) show significantly lower values in student population. Results of Titmus test in the student group is significantly worse than in the nonstudent group (t test 0.000). Maddox wing resulted in significantly higher degree of heterophoria in the student population (t test 0.000). Myopic subjects, in the student group (t test 0.002) as well as in the nonstudent group (t test 0.001), show significantly better results in Titmus test. CONCLUSIONS: High near visual demand could be the most important factor for higher incidence of myopia, worse convergence and fusion amplitude, higher degree of exophoria, and worse results in Titmus test in the student population.

Case-control study of multiple myeloma with special reference to diet as risk factor.

The case-control study was conducted in Belgrade (Yugoslavia) during the period 1994-1998. The objective of the study was to investigate factors related to the occurrence of multiple myeloma (MM). The study group consisted of 100 newly diagnosed MM patients and the same number of matched hospital controls. In the analysis conditional univariate and multivariate logistic regression were applied. According to multivariate analysis the following factors were significantly related to MM: smoking > or =25 cigarettes per day (Odds ratio--OR=6.7, 95% confidence interval--95% CI=1.3-34.3); having more than two brothers (OR=2.7, 95% CI=1.3-5.3), rheumatoid arthritis in personal history (OR=4.2, 95% CI=1.2-14.8), and frequent (4-7 times per week vs. lower frequency) consumption of yogurt (OR=3.1, 95% CI=1.6-6.0) and vegetables (OR=0.4, 95% CI=0.1-1.0).

Risk factors for basal cell carcinoma.

The aim of this study was to assess the risk factors for basal cell carcinoma (BCC). A case-control study, carried out in two towns in Yugoslavia, comprised 200 BCC cases and 399 controls. For statistical analysis, univariate and multivariate logistic regressions were used. The risk factors found for BCC were: freckling before the age 15, seven or more weeks per year spent at the seaside during holidays (lifetime average), outdoor work during summer-time, occupational exposure to organic and non-organic dissolvents and organophosphatic compounds, use of tar for cosmetic purposes, and previous BCC in personal history. Subjects who tended to burn and not to tan after sun exposure also showed a significantly higher risk for BCC. Brown eyes and history of acne had a protective effect. This study confirmed the role of both constitutional and environmental factors in the development of BCC.

Infectious diseases mortality in central Serbia.

STUDY OBJECTIVE: To determine the influence and the effect of the war in the former Yugoslavia and of the United Nations economic sanctions on mortality from infectious diseases. DESIGN: This was a descriptive study analysing mortality data time series. SETTING: Central Serbia, Yugoslavia. PARTICIPANTS: The population of central Serbia was the subject of the study (about six million inhabitants). MEASUREMENTS: Mortality rates were standardised directly, using the "European population" as the standard. Regression analysis and analysis of covariance were undertaken. MAIN RESULTS: During the period 1973-93, mortality from infectious diseases showed a decreasing trend. From 1987-90, and infectious diseases was significantly higher than expected on the basis of the trend for the preceding period (p = 0.020 and p = 0.00). In addition, there was a statistically significant departure from the preceding trend (p = 0.036) in men between 1991 and 1993 (the period of the war and UN sanctions)--the main effect being in younger age groups. CONCLUSION: The economic crisis in the former Yugoslavia during the 1980s followed by the outbreak of the war and the damaging effects of UN economic sanctions had a distinctly adverse effect on mortality from infectious diseases.

Effect of caffeine intake during pregnancy on birth weight.

The aim of this study was to examine the effect of caffeine consumption during pregnancy on birth weight and its possible interaction with smoking. The sample included 1,011 women who were interviewed during their first 3 days after delivery in one of the hospitals of Belgrade, Yugoslavia. A significant reduction in birth weight was found to be associated with an average caffeine intake of > or = 71 mg per day, after adjustment for gestational age, infant sex, parity, and maternal height and weight, but only in infants born to nonsmoking mothers.

Risk factors for Graves' disease.

A case-control study of 100 newly diagnosed patients with Graves' disease and the same numbers of controls matched with respect to sex, age (+/- 2 years) and type of residence (rural-urban) was carried out. According to the matched analysis (McNemar's test and 6 test) seventeen variables recognized as risk factors were included into the model of multivariate conditional logistic regression. The following factors were significantly associated with the occurrence of Graves' disease: change in time spent on work-much overtime work, second job, much less work than usual (RR = 6.62; CI = 2.08-21.01), lack of readiness of relatives and friends to help the subjected (RR = 1.48; 95% CI = 1.14-1.93), increased arguments with spouse (RR = 14.12; 95% CI = 1.63-121.87), unemployment for at least one month (RR = 9.80; 95% CI = 1.13-85.02), and family history of Graves disease in the first degree of relation (RR = 7.20; 95% CI = 0.85-60.70).

Diet and prostate cancer: a case-control study.

A case-control study, performed in two towns of Serbia (Yugoslavia) from 1990 to 1994, comprised 101 patients with histologically confirmed prostate cancer and 202 hospital controls individually matched by age (+/-2 years), hospital admittance and place of residence. Dietary information was obtained by using a standard questionnaire. After adjustment for possible confounders, risk factors for prostate cancer appeared to be the highest tertile of protein (odds ratio (OR) = 13.54, 95% confidence interval (CI) = 2.38-77.13), saturated fatty acid (OR = 3.63, 95% CI = 1.03-12.79), fibre (OR = 4.02, 95% CI = 1.38-11.73), and vitamin B12 intake (OR = 2.07, 95% CI = 1.08-3.97); a protective effect was found for the highest tertile of alpha-tocopherol (OR = 0.15, 95% CI = 0.05-0.53), calcium (OR = 0.37, 95% CI = 0.14-0.99) and iron intake (OR = 0.34, 95% CI = 0.12-0.95). There were significant (P < 0.05) linear trends in the odds ratios for alpha-tocopherol, vitamin B12, calcium and iron. According to logistic regression step by step analysis, risk factors for prostate cancer were dietary intake of retinol equivalent (OR = 1.64, 95% CI = 1.01-2.67) and vitamin B12 (OR = 1.87, 95% CI = 1.15-3.05), and a protective effect was found for dietary intake of iron (OR = 0.40, 95% CI = 0.27-0.58).

Stressful life events in the pathogenesis of Graves' disease.

A case-control study was conducted in order to assess possible relationships between life events and Graves' disease. The study included 100 newly diagnosed patients with Graves' disease and 100 controls matched with respect to sex, age ( +/- 2 years) and type of residence (rural, urban). Paykel's Interview for Recent Life Events (a semistructured research interview covering 61 life events) was administered to each subject. In comparison with controls, the patients claimed to have had significantly more life events in the 12 months preceding the diagnosis (p = 0.0001). The following eight life events were significantly more prevalent among patients than controls: change in time spent on work (much overtime work, second job, much less work than usual) (McNemar = 12.04; RR = 7.00; 95%CI = 2.35-20.80; p = 0.0001), unemployment for at least 1 month (McNemar = 4.00; RR = 8.00; 95%CI = 1.04-61.39; p = 0.039), arguments with one's superior at work or a co-worker (McNemar = 4.50; RR = 3.50; 95%CI = 1.10-11.08; p = 0.031). change in the work conditions (new company division, new chief, large reorganization) (McNemar = 4.26; RR = 4.00; 95%CI = 1.07-14.92; p = 0.035), increased arguments with spouse (McNemar = 6.75; RR = 11.00; 95%CI = 1.82-66.44; p = 0.006), increased arguments with fiancé/fiancée or a steady date (McNemar = 4.00; RR = 8.00; 95%CI = 1.04-61.39; p = 0.039), hospitalization of a family member for serious illness (McNemar = 3.76; RR = 3.25; 95%CI = 1.01-10.68; p = 0.049) and moderate financial difficulties (McNemar = 8.50; RR = 3.25; 95%CI = 1.47-7.16; p = 0.003). Our findings indicate that life events may be a risk factor for Graves' disease.

Uroflow via stenotic urethra.

A DANTEC 2100 mictometer type 21C10 with uroflow transducer type 21KO2 was used for investigation of 50 men with urethral strictures (mean age 59 +/- 14 years). The patients underwent a total of 334 clinical evaluations of replicate voiding (minimum 4, maximum 16) before and after successful urethral dilatation on an outpatient basis. Using t-paired comparison test, significant increase in maximum urinary flow rate (P less than 0.01) after the treatment procedure was evidenced in each of the patients. The variability of other urinary flow parameters suggested a lower significance in evaluation of urine stream quality. The McNemar test showed a significant shift from one to another zone of classification suggested by Drach et al. (P less than 0.01), i.e. 64% of patients reached normal or overlap zone in the first spontaneous voiding after urethral dilatation. Furthermore, no significant difference could be established with one-way ANOVA between urodynamic variables of mean values of repetitive voidings in cases of urethral stenosis of different aetiology either before or after urethral dilatation (P greater than 0.05), suggesting that urethral stenoses of different aetiology are characterized by similar urodynamic features. A highly significant linear correlation was found between the maximum flow rate and the voided volume only after urethral dilatation (r = 0.522, P less than 0.01), while correlation with urethral sound sizes could not be established (r = 0.207, P greater than 0.5). We conclude that uroflowmetry provides reliable information on the patient's ability to void. The use of maximum flow rate may predict the time at which urethral dilatation becomes necessary and provides objective evidence of the efficacy of treatment.

Non-antireflux versus antireflux ureteroneocystostomy in adults.

A retrospective analysis of ureteric reimplantation in adults showed that a high proportion (71%) had been treated by non-antireflux procedures. Analysis of the ureteroneocystostomy success rate in aetiological groups where either antireflux or non-antireflux techniques were used indicated the superiority of antireflux surgery in the prevention of reflux. The risk of stenosis at the site of anastomosis was equal in both groups. No significant difference in the preservation of renal function was detected in the 2 groups. It was concluded that antireflux procedures offered no advantage over non-antireflux ureteric reimplantation in adults.

Perforating branches of the middle cerebral artery. Microsurgical anatomy of their extracerebral segments.

Perforating branches of the middle cerebral artery (MCA) were examined under magnification in 50 formalin-fixed brain hemispheres. Perforating vessels varied in number from three to 18, with an average of nine. The greater the number of vessels, the smaller was their diameter. In this study, the perforating arteries were divided into medial, middle, and lateral groupings. Those in the medial group usually arose directly from the MCA main trunk close to the carotid bifurcation. There were usually three vessels in the middle group, which originated not only from the MCA trunk, but also from the MCA collateral (cortical) branches. Common stems, when present, gave rise to individual perforating vessels and occasionally to thin olfactory and insular rami. Perforating arteries in the lateral group varied from one to nine in number. In addition to an origin from the MCA trunk, they also arose from cortical branches supplying the frontal and temporal lobes. The fact that lateral perforating vessels often originated from division sites and from terminal branches of the MCA is of clinical significance, because aneurysms are more commonly located at the MCA bifurcation. Anastomoses were not found among the perforating arteries. In two specimens, a fusion between a perforating artery and the MCA trunk was noted. Since the perforating vessels are obviously end arteries, injury to them must be avoided during operations for MCA aneurysms.