Relationship between incidence of chronic obstructive pulmonary disease and lung cancer as comorbidity in primary health care in two Belgrade communities.

PURPOSE: To investigate the recent trends in the incidence of chronic obstructive pulmonary disease (COPD) and lung cancer as comorbidity in primary health care (Community Health Center, Zemun, Belgrade, which covers two municipalities - Surchin and Zemun), during the period 2014-2017. METHODS: This retrospective study analyzed the incidence of COPD and lung cancer as comorbidity in a 4-year period. Data were derived from the Heliant information system. Descriptive statistics -frequencies and percentages - were used, and differences between groups were tested by x2 test. RESULTS: The number of patients with COPD was slightly, but insignificantly, higher each consecutive year. Lung cancer as comorbidity appeared in about 11% of these patients. As for gender, male and female patients contributed equally to the number of patients with CORD. CONCLUSION: The number of patients with COPD registered in primary health care was similar in all investigated years. Lung cancer as comorbidity was found in a significantly smaller number of these patients.

Usefulness of human epididymis protein 4 in predicting optimal cytoreductive therapy in patients with advanced ovarian cancer.

PURPOSE: Human Epididymis Protein 4 (HE4) is a novel promising serum biomarker of high sensitivity and specificity for ovarian cancer (OC). We investigated the usefulness of HE4 in predicting the outcome of surgery of advanced OC. METHODS: Fifty patients with OC (FIGO stage III and IV) entered the study. Serum concentrations of HE4 and CA125 were evaluated preoperatively. All patients had been operated between January 2014 - January 2016. RESULTS: Preoperatively, the mean concentration of HE4 was 628pmol/L. Optimal cytoreduction was achieved in 44% of the patients, accompanied with decline of the mean values to HE4 478pmol/L, while in patients with suboptimal cytoreduction these values were 756pmol/L (p<0.001). Optimal cytoreduction was achieved in 52.9% of the patients with ascites ≤1,000 ml and in 48% of those with ascites >1,000 ml (p=0.023). These patients had preoperative values of HE4 405 and 713pmol/L, respectively (p=0.001). Optimal debulking was achieved in those patients with positive lymph nodes and ascites >1000ml, whose preoperative values of HE4 and CA125 were <413pmol/L and <500U/ mL, respectively. Our results indicated that the significant predictor of optimal cytoreduction was the value of HE4≤413pmol/L. In patients whose preoperative values HE4 were ≥413pmol/L the optimal cytoreduction was less probable (odds ratio 4.921, p=0.021). CONCLUSION: Preoperative concentrations of HE4 can be of predictive value for the achievement of optimal debulking of OC. Additional research in larger populations is necessary to prove the ability of preoperative values of HE4 in helping answer the question of whether or not optimal cytoreduction would be achieved.

Association of human papillomavirus infection with cytology, colposcopy, histopathology, and risk factors in the development of low and high-grade lesions of the cervix.

PURPOSE: Persistent human papilloma virus (HPV) infection is fundamental for the development of intraepithelial neoplasia and cervical cancer. The aim of this study was to examine the association between HPV infection and cervical cytology, colposcopy, biopsy and the risk factors entailed. METHODS: The study included 784 patients tested by in situ hybridization for HPV type 6/11, 16/18 and 31/33/35 infection. The participants were divided into three categories according to the presence of high squamous intraepithelial lesions (H-SIL), low squamous intraepithelial lesions (L-SIL) and benign histologic findings. RESULTS: Patients that had L-SIL and H-SIL demonstrated a significantly higher percentage of HPV infection than patients with benign histologic findings. The percentage of H-SIL was highest in patients infected with high risk (HR)-HPV types 16/18, who had sexual intercourse before the age of 16 years, with two to five sexual partners. CONCLUSION: Among high-grade intraepithelial neoplasia, there is a high prevalence of HR-HPV types 16/18, which is associated with the number of sexual partners and early sexual activity. There was a significant association between the presence of abnormal cytology and HR-HPV 16/18 in both groups (H-SIL and L-SIL). Benign colposcopic findings were not found in any patient with H-SIL, where no patient had only one sexual partner.

The importance of quality control in the implementation of breast cancer screening program in the Health Center Zemun.

PURPOSE: To investigate whether the differences in implementation between opportunistic and organized breast cancer screening affect the results, as well as the significance of quality control during the implementation of organized breast cancer screening. METHODS: Testing was performed in 2013 (opportunistic screening) and 2014 (organized screening) in the Health Centre Zemun. This included female population aged 50-69 years, belonging to the target population according to the national breast cancer screening programs. The Health Centre Zemun database of insured patients from the National Health Insurance Fund of the municipality of Zemun and Surcin was used for the evaluation of the screening performance. Statistical data processing was done with the statistical package SPSS-20.0. RESULTS: There was a highly significant difference (p=0.000) in the implementation of opportunistic and organized screening, whereby the response of women in organized screening was much greater (11.48%) than of the women responding to opportunistic screening (0.27%). The low response of women noticed in the summer in organized screening was attributed to the fact that the majority of women in Serbia take their holidays in that period. CONCLUSION: Performance and quality of screening depends on the control of all segments of the activities carried out in the screening process. Previous experience in organizing and controlling the quality of the implementation of screening can serve as a proven model, which by a multidisciplinary approach in practice can provide a better and safer healthcare.