Psychological well-being in advanced NSCLC patients in Serbia: impact of sociodemographic and clinical factors.

UNLABELLED: Patients with advanced non-small cell lung cancer (NSCLC) usually undergo toxic treatment (chemotherapy and/or radiotherapy). They can experience devastating effects of illness and therapies on their psychological and emotional well-being. On the other hand, untreated psychological distress is associated with reduced quality of life and inadequate palliation of physical symptoms.
In order to estimate frequency of anxiety and depressive symptoms and influence of demographic, socioeconomic and clinical factors on psychological well-being, we performed this cross-sectional study in group of 100 patients with advanced stage of disease. Symptoms of anxiety and depression were assessed using the Hamilton Anxiety Rating Scale (HARS) and Hamilton Depression Rating scale (HDRS). Health-related quality of life data are obtained by EORTC QLC C30 and SF 36.
Patients with poor performance status (PS) experienced significantly more anxiety and depressive symptoms (p=0.001) and worse emotional (p=0.001) and mental functioning (p=0.001). Treated patients had significantly better mental (p=0.011) and emotional (p=0.001) functioning in compared to newly diagnosed ones. Somewhat unusual, unemployed participants reported significantly less anxiety (p=0.029) and depressive (p=0.002) symptoms, better mental (p=0.030) and emotional functioning (p=0.007). Additionally, nausea and vomiting adversely affected mental health and emotional functioning and correlated significantly positively with HARS and HDRS scores.
Our findings suggest significant impact of some disease-related factors (PS, active treatment) and treatment-related factors (chemotherapy -induced nausea and vomiting) on psychological well-being of patients with advanced NSCLC. This should be taking an account when appropriate interventions are planned. KEYWORDS: lung cancer, anxiety, depression, quality of life, chemotherapy, chemotherapy-induced nausea and vomiting.

[Pediatric brain tumors--diagnostic and treatment].

During the period 1995-2004 we treated 212 patients (pts) with brain tumors. There were 133 boys and 79 girls, aged from 2,5 yrs up to 18 yrs (Me = 9, 7 yrs). The majority of pts were in age group (4-16) yrs-179 pts. Supratentorial tumors were diagnosed in 118 pts vs. infratentorial 94 pts. Therapy involved surgery, postoperative radiotherapy with or without chemotherapy. Survival rates were calculated using Caplan-Meier method and differences between curves with log-rank test. During the follow-up period from 1 to 9 year (Me = 3 yrs) 5-year disease free survival rate was 55.7%. 79 pts failed to therapy. There was no statistically significant difference in survival according to sex (p = 0.123) and age (p = 0.367). Pts with supratentorial tumors had statistically significant better survival (p = 0.036). Pts with histologic type low grade astrocitomas had statistically significant better survival than malignant gliomas, ependymomas and PNET (p = 0.0001). Surgery, postoperative radiotherapy and chemotherapy in selected cases are efficient therapeutic approach for pediatric brain tumors.

Risk factors from brain tumors in children and adolescents: a case-control study in Belgrade, Serbia.

The objective of the present study was to test the different hypotheses about factors related to the occurrence of brain tumors in children and adolescents. The case-control study of brain tumors was conducted in Belgrade (Serbia) from 1998 through 2000. The study group consisted of 60 newly diagnosed brain tumor patients and the same number of hospital controls. In the analysis conditional univariate and multivariate logistic regression were applied. According to the final model of multivariate analysis the following factors were significantly related to brain tumors: schooling of father <14 years (OR = 11.05, 95% CI 2.41-50.63, P = 0.002), mothers - housewives or workers versus clerks (OR = 2.62, 95% CI 1.06-6.57, P = 0.036), number of brothers and sisters greater than one (OR = 3.02, 95% CI 1.50-7.22, P = 0.001), and more frequent presence of malignant diseases, including brain tumors, in family history (OR = 3.54, 95% CI 1.30-9.60, P = 0.001). This case-control study was made to investigate different factors of possible importance for brain tumors in children and adolescents. Lower family social status, and more frequent occurrence of malignant tumors amongst relatives seem to be the factors that contribute the most to the higher risk of brain tumors.

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).

Febrile convulsions in a Serbian region: a 10-year epidemiological study.

The first population-based study in the central region of the Republic of Serbia (total population 283,103) was carried out to assess some epidemiological features of febrile convulsions among children of between 6 months and 5 years of age. During the 10-year period, 1986 to 1995, there were 570 cases of the first febrile convulsions (287 males and 283 females). The average annual incidence rate was 3/1000 (2.9/1000 in males and 3.0/1000 in females), with the highest in 1995. During the study period, a significantly increased linear regression trend was observed. During the follow-up period of 5 years for children who had their first febrile convulsions in 1989 and 1990 (total 154 cases), 27 (17.5%) had a recurrence of the disorder, and ten (6.5%) had one or more afebrile seizures, of whom seven children (4.5% of total sample) developed epilepsy (recurrent afebrile seizures).

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.

[Epidemiological characteristics of cancer of the pancreas in Serbia (without provinces)]. / Epidemioloske odlike raka pankreasa u Srbiji bez pokrajina.

Over the period from 1980 to 1993 the average age standardized mortality rate of cancer of the pancreas was 4.51 per 100000 of population (8.83% per hundred thousand in men and 3.37% per hundred thousand in women). Mortality rates were very low below the age of 34-0.09% per hundred thousand (0.14% per hundred thousand in men and 0.04% per hundred thousand in women). With aging rates showed steady increase, and they were the highest in the age group of 75 and more years--37.21% per hundred thousand (42.60% per hundred thousand in men and 33.60% per hundred thousand in women). During the period observed mortality of cancer of the pancreas showed an increasing trend (y = 3.50 + 0.11x), present in both sexes (y = 4.49 + 0.14x in men and y = 2.73 + 0.07x in women) and in all age groups exept in women aged 0-34 and 35-44 in whom a slightly decreasing trend was found.