Long-term trends of potential years of life lost due to main causes of death in the Slovak population, 2004-2013 / Tendências a longo prazo nos anos potenciais de vida perdidos devido às principais causas de óbito na população da Eslováquia, 2004-2013 / Tendencias a largo plazo de los años potenciales perdidos de vida, debido a las principales causas de muerte en la población eslovaca, 2004-2013

The aim of this study was to evaluate trends of potential years of life lost (PYLL) rates in the Slovak population and analyze the average annual percent change (AAPC) of PYLL rates regarding the most common causes of death between 2004 and 2013. National mortality and demographic data were obtained from the Statistical Office of the Slovak Republic, and 378,535 causes of death within the period were analyzed. The PYLL values in both genders and each disease category were added up across all age groups to form annual values. For the trend analysis, the AAPC indicator was proposed. The PYLL rate is age-standardized and expressed as a sum of all deaths per 100,000. In the period 2004-2013, the highest mean PYLL rates were observed in neoplasms in the whole population (2,103 per 100,000), as well as in females (2,088 per 100,000), with a permanent high significant increase of AAPC of PYLL in both genders. The second highest mean PYLL rate in the ten-year period was related to circulatory system diseases in total (1,922 per 100,000) as well as in females (1,449 per 100,000). In males, circulatory system diseases had the highest PYLL rate (2,397 per 100,000). The PYLL rates trend regarding external causes of morbidity and mortality showed the most notable decrease in the assessed period and the AAPC of PYLL showed significant negative values both in males (-2.5%; p < 0.001) and females (-4%; p < 0.001). Our results should contribute in developing intervention programs aimed at reducing the burden of premature mortality since the main causes of premature death are associated to well-known and preventable risk factors.

O estudo teve como objetivo avaliar as tendências nas taxas de anos potenciais de vida perdidos (APVP) na população eslovaca e a análise da variação percentual anual média (VPAM) nas taxas de APVP de acordo com as causas de óbito mais comuns no período de 2004 a 2013. A mortalidade nacional e os dados demográficos foram obtidos do Escritório de Estatística da República Eslovaca. Foram analisadas 378.535 causas de óbito entre 2004 e 2013. Para constituir os valores anuais, foram tabelados, em todas as faixas etárias, os valores de APVP em ambos gêneros e em cada categoria nosológica. Para a análise de tendências, foi proposto o indicador da VPAM. A taxa de APVP é padronizada para a idade e expressa como a soma de todos os óbitos por 100 mil. No período de 2004 a 2013, as médias mais altas de APVP foram observadas em neoplasias na população geral (2.103 por 100 mil) e na população feminina (2.088 por 100 mil), com um aumento significativo na VPAM dos APVP em ambos os gêneros. A segunda maior média de APVP no período de 10 anos foi devida a doenças cardiovasculares, tanto na população geral (1.922 por 100 mil) quanto na população feminina (1.449 por 100 mil). Na população masculina, as doenças cardiovasculares tiveram a maior taxa de APVP (2.397 por 100 mil). A tendência nas taxas de APVP por causas externas mostraram a redução mais importante no período avaliado, e a VPAM dos APVP comprovou os valores negativos significativos, tanto em homens (-2,5%; p < 0,001) quanto em mulheres (-4%; p < 0,001). Os resultados devem contribuir para o desenvolvimento de intervenções voltadas para a redução da carga de mortalidade prematura, considerando que as principais causas de morte prematura estão associadas a fatores de risco bem conhecidos e preveníveis.

El objetivo de este estudio fue evaluar las tendencias de las tasas de los años potenciales de vida perdidos (PYLL por sus siglas en inglés) en la población eslovaca y el análisis de la variación promedio del porcentaje anual (AAPC por sus siglas en inglés) de las tasas PYLL, de acuerdo con las causas más comunes de muerte, durante el período de 2004-2013. La mortalidad nacional y los datos demográficos se obtuvieron de la Oficina Estadística de la República Eslovaca; se analizaron 378.535 causas de muerte entre 2004 y 2013. Los valores de PYLL en ambos géneros y en cada categoría de enfermedad se contaron en todos los grupos de edad para formar valores anuales. Para el análisis de tendencia, se propuso el indicador AAPC. La tasa de PYLL se encuentra estandarizada por edad y expresada como la suma de todas las muertes por 100.000. En el período 2004-2013, las tasas medias más altas de PYLL se observaron en neoplasias en toda la población (2.103 por 100.000), así como en las mujeres (2.088 por 100.000) con un incremento significativo permanente alto de la AAPC en los PYLL en ambos géneros. La segunda tasa media más alta de PYLL, durante el período de diez años, se debió a las enfermedades del sistema circulatorio en total (1.922 por 100.000), al igual que en las mujeres (1.449 por 100.000). En hombres, las enfermedades del sistema circulatorio tienen la tasa más alta de PYLL (2.397 por 100.000). La tendencia de las tasas de PYLL, debida a causas externas de morbilidad y mortalidad mostró un notable decremento en el período evaluado y la AAPC de PYLL probaron los valores negativos significativos tanto en hombres (-2,5%; p < 0,001) como en mujeres (-4%; p < 0,001). Nuestros resultados deberían contribuir al desarrollo de la intervención en programas que tengan como meta reducir la carga de la mortalidad prematura, considerando que las causas principales de muerte prematura están asociadas a factores de riesgo bien conocidos y prevenibles.

Hashimoto's thyroiditis - an independent risk factor for papillary carcinoma / Hashimoto's thyroiditis - an independent risk factor for papillary carcinoma

Abstract Introduction: The link between Hashimoto's thyroiditis and thyroid carcinoma has long been a topic of controversy. Objective: The aim of our study was to determine the prevalence of thyroid carcinoma and Hashimoto's thyroiditis coexistence in histopathologic material of thyroidectomized patients. Methods: In a retrospective study, the clinicohistopathologic data of 2117 patients (1738 females/379 males), who underwent total or partial thyroidectomy for thyroid gland disorder at a single institution from the 1st of January 2005 to the 31st of December 2014 were analyzed. Results: Thyroid carcinoma was detected in 318 cases (15%) and microcarcinoma (thyroid cancer ≤10 mm in diameter) was found in permanent sections in 169 cases (8%). Hashimoto's thyroiditis was detected in 318 (15%) patients. Hashimoto's thyroiditis was significantly more often associated with thyroid carcinoma and microcarcinoma compare to benign condition (p = 0.048, p = 0.00014, respectively). Coexistence of Hashimoto's thyroiditis and thyroid carcinoma/thyroid microcarcinoma did not affect tumor size (p = 0.251, p = 0.098, respectively), or tumor multifocality (p = 0.831, p = 0.957, respectively). Bilateral thyroid microcarcinoma was significantly more often detected when Hashimoto's thyroiditis was also diagnosed (p = 0.041), but presence of Hashimoto's thyroiditis did not affect bilateral occurrence of thyroid carcinoma (p = 0.731). Conclusion: Hashimoto's thyroiditis is associated with significantly increased risk of developing thyroid carcinoma, especially thyroid microcarcinoma.

Resumo: Introdução: A relação entre a tireoidite de Hashimoto e o carcinoma de tireoide tem sido um tema de controvérsia por um longo tempo. Objetivo: Determinar a prevalência da coexistência de carcinoma de tireoide e tireoidite de Hashimoto no exame histopatológico de amostras de pacientes tireoidectomizados. Método: Em um estudo retrospectivo, foram analisados os dados clinico-histopatológicos de 2.117 pacientes (1.738 mulheres/379 homens), submetidos à tireoidectomia total ou parcial por distúrbio da glândula tireoide em uma única instituição, de 1º de janeiro de 2005 a 31 de dezembro de 2014. Resultados: O carcinoma de tireoide foi detectado em 318 casos (15%) e o microcarcinoma (câncer de tireoide ≤ 10 mm de diâmetro) foi encontrado em secções permanentes em 169 casos (8%). A tireoidite de Hashimoto foi detectada em 318 (15%) pacientes e foi associada ao carcinoma da tireoide e ao microcarcinoma com maior frequência em comparação com condições benignas (p = 0,048, p = 0,00014, respectivamente). A coexistência de tireoidite de Hashimoto e carcinoma/microcarcinoma não influenciou o tamanho do tumor (p = 0,251, p = 0,098, respectivamente) ou a multifocalidade tumoral (p = 0,831, p = 0,957, respectivamente). O microcarcinoma de tireoide bilateral foi detectado com maior frequência quando a tireoidite de Hashimoto também foi diagnosticada (p = 0,041), mas a presença de tireoidite não influenciou na ocorrência bilateral de carcinoma (p = 0,731). Conclusão: A tireoidite de Hashimoto está associada a um aumento significativo do risco do desenvolvimento de carcinoma de tireoide, especialmente microcarcinoma da tireoide.

Complications of Liver Resection in Geriatric Patients

Abstract: Introduction and aims. Liver resection is the treatment of choice for many primary and secondary liver diseases. Most studies in the elderly have reported resection of primary and secondary liver tumors, especially hepatocellular carcinoma and colorectal metastatic cancer. However, over the last two decades, hepatectomy has become safe and is now performed in the older population, implying a paradigm shift in the approach to these patients. Material and methods. We retrospectively evaluated the risk factors for postoperative complications in patients over 65 years of age in comparison with those under 65 years of age after liver resection (n = 360). The set comprised 127 patients older than 65 years (35%) and 233 patients younger than 65 years (65%). Results. In patients younger than 65 years, there was a significantly higher incidence of benign liver tumors (P = 0.0073); in those older than 65 years, there was a significantly higher incidence of metastasis of colorectal carcinoma to the liver (0.0058). In patients older tan 65 years, there were significantly more postoperative cardiovascular complications (P = 0.0028). Applying multivariate analysis, we did not identify any independent risk factors for postoperative complications. The 12-month survival was not significantly different (younger versus older patients), and the 5-year survival was significantly worse in older patients (P = 0.0454). Conclusion. In the case of liver resection, age should not be a contraindication. An individualized approach to the patient and multidisciplinary postoperative care are the important issues.

Impact of Orthodontic Treatment on Oral Health-Related Quality of Life in the Slovak Republic: A Cross-Sectional Study

Objective: To determine the level of Oral Health-related Quality of Life satisfaction in orthodontic patients compared with the control group. Material and Methods: In this cross-sectional study, the standardized questionnaire "Oral Health-related Quality of Life" (OHRQoL) was used. The 37 statements in the questionnaire are divided into four subscales; the total satisfaction score has been evaluated as well. 146 orthodontic patients (42.5% men) aged 8-72 years were divided into four subgroups: (i) patients treated by dental crowns and implants (DCI), (ii) subjects with dental prosthesis (DP), (iii) patients treated by dental braces (DB), and (iv) patients treated by dental retainer (DR). The control group consisted of 49 dental patients without any orthodontic treatment (51.0% men in mean age 20.0±8.2 years). Mean scores and levels of satisfaction (%) were evaluated in all subgroups and in all subscales. Results: The lowest rate of patients OHRQoL satisfaction was observed in the DP subgroup; the highest satisfaction level was found in the DCI subgroup. The highest rate of patient OHRQoL satisfaction in the study group was observed in subscales social well-being and functional limitation, and the highest level of dissatisfaction in a subscale emotional well-being. High significant differences between study and control groups were found in terms of a higher satisfaction level in a control group. Conclusion: The most dissatisfied were the oldest patients with dental prosthesis with the highest level of dissatisfaction in the emotional well-being subscale.

Введение оценки воздействия на здоровье в Трнаве, Словакия: практический пример: oценка воздействия на здоровье - руководство для городов

В документе представлен пилотный проект по оценке воздействия на здоровье (ОВЗ), который проходил в Трнаве, Словакия с марта по сентябрь 2004 в рамках проекта «Развитие и поддержка интегрированных подходов к здоровью и устойчивому развитию на местном уровне в Европе» (проект PHASE). По ходу данного проекта был подготовлен литературный обзор, касающийся аспектов политической и административной системы на национальном и местном уровне в Словакии; были проведены три совещания в городе Трнава.

Introducing health impact assessment in Trnava, Slovakia: a case study: Health Impact Assessment Toolkit for Cities

This document explains the pilot project on health impact assessment (HIA) that took place in Trnava, Slovakia from March to September 2004 based on Promoting and Supporting Integrated Approaches for Health and Sustainable Development at the Local Level across Europe (PHASE Project). A literature search of the political and executive system at the national and local level in Slovakia was conducted followed by three HIA meetings in the City of Trnava. The first meeting raised awareness for a wide audience to gain political commitment for HIA. The second meeting provided in-depth training of HIA for the local officers in Trnava who were going to carry out the HIA. The third meeting evaluated the HIA process. Interviews were conducted with all participants (administrative officers, directors, Vice-Mayor, healthy city coordinator and the researchers), who also filled in a questionnaire to assess the application and introduction of HIA. An HIA steering group was created with the aim of conducting a pilot appraisal to identify the likely health effects of a selected proposal for building a new playground for children in the city. The work was carried out in multisectoral and intersectoral collaboration, including officers from different departments. The results of the evaluation showed barriers to and enablers for introducing HIA in Trnava. The introduction can been seen in two strands: the executive and administrative strand and the political strand. Regarding the executive and administrative strand, the advantage was that the officers were already collecting data to carry out risk appraisal. However, the risk appraisal reports were minimally disseminated between the departments because of a lack of intersectoral collaboration on health-related issues. The officers also related the somewhat contradictory sense that, although more time and training will be required to fully implement the HIA process, this process was a way of learning by doing. HIA needs to be performed to fully understand its benefits. Regarding the political aspects, the evaluation showed that political commitment and support are very valuable in introducing the HIA process. The participants stated that there was clear political commitment to HIA but not enough support for time and resources. A call for introducing a legal requirement for HIA was issued at all meetings during the pilot phase. In the absence of a legal framework stipulating HIA, there is a need to build on existing capacity, legislation and other resources such as environmental impact assessment.

10 health questions about the 10

Ten countries joined the previously 15-member European Union (EU15) on 1 May 2004, creating EU25. The health status of the population varies among the new members, and sometimes between them and EU15. Similarly, their health systems show different patterns of development. How does each of the new EU members compare in terms of health to the old members? This book offers a quick and easy way to grasp the essential features of health and health systems in the 10 newcomers. Each chapter provides a concise overview of key health indicators in 1 of the 10, compares these indicators to EU15 averages, summarizes the key aspects of the country’s health system and describes what it has achieved after a decade of health reform. This book is not a comprehensive in-depth study, but an easy guide to the knowledge available. It offers valuable reading for anyone who wants to have a quick, straightforward and accurate entry point to understanding health in the 10 new EU member states.