Violent deaths among adolescents in Serbia: past, present and future.

OBJECTIVES: The aim of the study was to determine the trend and methods of violent deaths (suicide and homicide) in adolescents aged 15-19 years in Serbia. METHODS: Mortality database was drawn from the Statistical Office of Serbia from the 1997-2019 period. To calculate the annual percentage change (APC) of mortality rate (MR) with corresponding 95% confidence interval we used join point regression analysis. Statistical analyses were also performed using the chi-square test and Spearman's rho correlation. RESULTS: The average suicide rate was 3.65 per 100,000 and homicide rate was 1.36 per 100,000 adolescents. The boys to girls ratio was 4.2 for suicides and 2.7 for homicides. Among girls, suicide rate significantly decreased (APC -20.7%; 95% CI -32.5 to -6.8) and homicide rate insignificantly decreased (APC -19.3%; 95% CI -37.8 to 5.1). Among boys, suicide rate significantly decreased (APC -4.6%; 95% CI -7.0 to -2.0) as well as homicide rate (APC -7.7%; 95% CI -11.5 to -4.3). The most common method of suicide was hanging (195, 44.3%) and nearly one third (198, 32.6%) of violent deaths were caused by firearms. Significantly negative correlation was observed between the Human Development Index (HDI), gross domestic product (GDP) per capita and MR due to suicides and homicides among both genders (p < 0.05). CONCLUSIONS: Increase of GDP and HDI, national preventive intervention and strict application of the provisions of the law regarding the possession and storage of weapons must be implemented in order to continue reducing violent deaths among adolescents.

Oxidative stress biomarkers in amniotic fluid of pregnant women with hypothyroidism.

Purpose: Hypothyroidism in pregnancy is the serious state that may lead to fetal morbidity and mortality. Oxidative stress biomarkers in the amniotic fluid can provide important information on the health, development and maturation of the fetus during pregnancy. In this study, we examined whether maternal hypothyroidism contributes to increased oxidative stress biomarkers in the amniotic fluid during the first trimester of pregnancy. Materials and methods: The study was conducted on healthy pregnant women and pregnant women with hypothyroidism (gestational age: 16-18 weeks). Oxidative stress biomarkers, such as superoxide anion (O2•-), hydrogen peroxide (H2O2), nitric oxide (NO), peroxynitrite (ONOO-), lipid peroxide (LPO), reduced glutathione (GSH) and oxidized glutathione (GSSG) were assayed in the amniotic fluid. Results: The results of this study indicated that concentrations of O2•- and NO are significantly higher, while the concentration of H2O2 is significantly lower in the amniotic fluid of pregnant women with hypothyroidism in comparison to healthy pregnant women. There were no differences in concentrations of LPO, GSH and GSSG among tested groups. Also, we found that amniotic fluid concentration of O2•- is negatively correlated with the body weight and Apgar score values of the newborns. Conclusion: These results suggest that pregnancy hypothyroidism is characterized by the amniotic fluid oxidative stress. Incorporation of the oxidative stress biomarkers measurement in the amniotic fluid may be of clinical importance in the management of pregnancy hypothyroidism.

Effects of maternal subclinical hypothyroidism on amniotic fluid cells oxidative status.

In this study, we researched the effects of maternal subclinical hypothyroidism on the amniotic fluid cells oxidative metabolism during the first trimester of pregnancy. Oxidative stress and damage biomarkers were assayed in the amniotic fluid cells of healthy and pregnant women with subclinical hypothyroidism. Obtained results show that amniotic fluid cells of pregnant women with subclinical hypothyroidism have significantly higher concentrations of oxidative stress biomarkers (superoxide anion, nitric oxide, peroxynitrite) and oxidative damage (lipid peroxide and micronuclei frequency), but lower concentrations of hydrogen peroxide and oxidized glutathione in comparison to healthy pregnant women. We also showed that oxidative stress biomarkers were positively correlated with micronuclei frequency and lipid peroxide concentration in amniotic fluid cells of pregnant women with subclinical hypothyroidism. The present study provides the first evidence for prooxidative effects of maternal subclinical hypothyroidism on the fetus obtained by the estimating oxidative metabolism in the amniotic fluid cells.

The impact of the July 2007 heat wave on daily mortality in Belgrade, Serbia.

OBJECTIVE: Mortality has been shown to increase with heat waves. Serbia experienced the hottest heat wave in July 2007. In this study, we examined patterns of non-traumatic excess mortality in Belgrade during this event. METHODS: The numbers of deaths observed during the 9-day heat wave were compared to those expected on the basis of mortality rates reported for the previous eight years and two following years. Excess mortality was analyzed by age, gender and cause of death. RESULTS: There was a total of 167 excess deaths (38%) between 16 and 24 July. People aged 75 years and older accounted for 151 (90%) of all excess deaths. An increase of mortality among elderly was 76% in comparison to the baseline mortality. Excess female mortality was over two times higher than excess male mortality (54% : 23%). The biggest increase in mortality was from diabetes mellitus (286%), chronic kidney disease (200%), respiratory system diseases (73%), and nervous system diseases (67%). Cardiovascular and malignant neoplasms mortality accounted for the highest absolute numbers of excess deaths (77 and 49, respectively). There was no decrease in mortality in the 60-day period after the heat wave. CONCLUSIONS: There are several causes of an increase in heat-related mortality. The most vulnerable population group is the elderly females.

Excess winter mortality of Roma population in Serbia, 1992-2007.

OBJECTIVES: Seasonal fluctuations in mortality are associated with age, outdoor temperature, influenza, health care provision, lifestyle risk factors and economic factors. In the Republic of Serbia almost one half of the Roma population lives in poverty and their housing conditions are very poor. The aim of this paper is to describe and compare excess winter mortality (EWM) in Roma and non-Roma population in Serbia from 1992 to 2007. METHODS: Using the national mortality database, this study compares EWM index and rates in Roma and general populations in Serbia. Mean winter temperature and ethnicity are analysed against the results for relative EWM by multiple linear regression adjusted for age. RESULTS: Frequency analysis showed that Roma population had significantly higher EWM rate per 10,000 (129.2 vs. 76.6) for all causes, all respiratory diseases (26.5 vs. 8.0), and chronic lower respiratory diseases (23.0 vs. 5.2) in comparison to non-Roma population. Influenza and pneumonia related deaths represented a small proportion of EWM in both populations. Cardiovascular EWM rate was slightly higher among non-Roma population. Regression analysis demonstrates that Roma ethnicity was associated with significant increase of respiratory EWM rate (regression coefficient (B) = 1.49; 95% CI: 0.45-2.54). There was no relationship between ethnicity and cardiovascular and all causes EWM rates. CONCLUSIONS: Although both Roma and non-Roma populations in Serbia suffer from very high rates of excess winter mortality, Roma are significantly more vulnerable. EWM rate from chronic lower respiratory diseases is more than four times higher among Roma people and suggests that they represent one of the most important health problems in Roma population in Serbia.