Smartphone addiction, sleep quality, depression, anxiety, and stress among medical students.

Introduction: Studies consistently link excessive smartphone use to poor sleep quality, depression, anxiety, and stress. This study specifically aimed to investigate these associations among medical students in Belgrade and Nis (Central Serbia). Materials and methods: The cross-sectional study included a sample of 761 students, who were selected from both the Faculties of Medicine at the University of Belgrade and the University of Nis. Questionnaires, including the International Physical Activity Questionnaire - Short Form (IPAQ-SF), Smartphone Addiction Scale - Short Version (SAS-SV), the Pittsburgh Sleep Quality Index (PSQI), and the Depression, Anxiety, and Stress Scale - 21 items (DASS-21), were completed by the participants. Statistical analysis techniques, such as the Chi-square test, student's t-test, and logistic regression, were employed to examine the relationship between smartphone addiction, physical activity, sleep quality, depression, anxiety, and stress. Results: The findings indicated a prevalence of smartphone addiction among medical students at 21.7%, with rates of 22.9% among males and 21.1% among females. Females exhibited significantly higher scores on the SAS-SV scale compared to males (p = 0.032). Univariate logistic regression analysis revealed significant associations between smartphone addiction and spending over 4 h daily on smartphones (OR = 2.39; p < 0.001), poor sleep quality (OR = 1.65; p = 0,005), as well as elevated levels of stress (OR = 1.75; p = 0.003), anxiety (OR = 2.04; p < 0.001), and depression (OR = 2.29; p < 0.001). Multivariate regression analysis identified spending more than 4 h daily on smartphones (OR = 2.39; p < 0.001) and increased levels of depression (OR = 2.51; p < 0.001) as independent significant factors associated with smartphone addiction. Conclusion: This study sheds light on the prevalence of smartphone addiction among medical students, with spending excessive time on smartphones and higher levels of depression standing out as significant factors. Future research should delve into the underlying mechanisms and causal relationships between smartphone addiction and these psychosocial factors. Understanding these connections will aid in developing effective interventions and strategies to tackle this growing public health concern.

Predictors of Anxiety Before and After Diagnostic Procedures in Women with Abnormal Papanicolaou Smear in Cervical Cancer Screening Program.

Anxiety is one of the most common causes of withdrawal from follow-up among women with abnormal Papanicolaou screening results. The purpose of this study was to investigate predictors of anxiety in women with abnormal Papanicolaou smear in cervical cancer screening program. A population-based, cross-sectional study concerning the factors related to anxiety was carried out during 2017 in a cohort of women (N = 172) with positive Papanicolaou screening test before and after diagnostic procedures (colposcopy/biopsy/endocervical curettage) at one university Clinical Center in Serbia. Women completed a socio-demographic questionnaire and scale concerning anxiety (Hospital Anxiety and Depression Scale, subscale HADS-Anxiety) immediately before and 2-4 weeks after the diagnostic procedures. Multivariate logistic regression was applied in the data analysis. In our study, 35.2% (n = 52) of women had abnormal anxiety scores before the diagnostic procedures and 40.1% (n = 69) after the diagnostic procedures. Predictors of anxiety before diagnostic procedures were family history of noncervical gynecological cancers, higher level of worry and high burden of depressive symptoms. Significant independent predictors of anxiety after diagnostic procedures in women were rural residence, tension and discomfort during medical procedures, and less satisfaction with information/support. Although there was no significant difference in the prevalence of anxiety before and after diagnostic procedures in women with abnormal Papanicolaou screening results, results of this research will enable doctors to successfully make decisions concerning timely psychological support for women with positive screening test for cervical cancer that is necessary to decrease anxiety in our population.

Characteristics and quality of life of substance users and their caregivers.

The correlation between substance use and depression has been emphasized in the literature. Substance use disorders can also adversely affect the caregivers of drug-addicted persons. A cross-sectional study was conducted at the Special Hospital for Addiction Diseases in Belgrade in 2015 to analyze the characteristics, consequences, and health-related quality of life of drug users and their caregivers. The sample comprised 136 users of various substances, and 136 caregivers. A questionnaire on socio-demographic characteristics, the Short Form Health Survey 36 (SF-36), and Beck Depression Inventory were administered to all participants. According to multivariate logistic regression analysis, compared with caregivers, substance users were significantly more frequently male (P < .001), ≤ 39 years old (P < .001), and more frequently reported the use of sedatives (P = .009) and smoking (P < .001). Some level of depression was present in all participants, but severe forms were more frequent in substance users (P = .010). Among substance users, mean scores of SF-36 domains ranged from 56.62‒87.17, and among their caregivers, from 50.37‒75.07; however, the difference was significant only for the health change domain (P = .037), the score for which was lower in caregivers. Substance users suffered from more severe forms of depression compared to their caregivers, who had lower SF-36 scores in the domain of health change.

Cigarette Smoking and E-Cigarette Use by Pharmacy Students in Serbia.

The purpose of this study was to assess the use of e-cigarettes among pharmacy students. In 2016, we conducted a cross-sectional study among pharmacy students enrolled at the University of Kragujevac (Serbia). Overall, 47.0% of pharmacy students reported that they ever smoked cigarettes; 29.7% were former and 17.3% were current smokers. The overall prevalence of e-cigarette use was 9.9%. The final year pharmacy students significantly more frequently smoked tobacco cigarettes (p = .001) and used e-cigarettes (p = .009) compared to younger students. Also, alcohol use was positively related to ever smoking tobacco cigarettes (adjusted OR = 4.57, 95% CI = 2.80-7.43; p < .001) and to ever use of e-cigarettes (adjusted OR = 5.58, 95% CI = 1.58-19.71; p = .008). The pharmacy students who ever used e-cigarettes more frequently reported a history of self-funded study financing (adjusted OR = 14.68, 95% CI = 2.42-89.17; p = .004) and use of psychoactive substances (adjusted OR = 13.63, 95% CI = 2.52-73.69; p = .002). In pharmacy students, a higher overall grade was related to a significantly less frequent ever use of tobacco cigarettes (adjusted OR = 0.43, 95% CI = 0.22-0.84, p = .015). This paper highlights the need for a more effective tobacco control among pharmacy students in Serbia in order to reduce smoking prevalence.

Effects of adding necitumumab to first-line chemotherapy in patients with stage IV non-small-cell lung cancer: Meta-analysis.

INTRODUCTION: Almost half of patients with non-small-cell lung cancer (NSCLC) are diagnosed at an advanced stage. Our aim was to assess the effects of adding necitumumab to chemotherapy in patients with stage IV NSCLC. MATERIAL AND METHODS: A comprehensive literature search was performed according to pre-specified inclusion and exclusion criteria. Data on overall survival, progression-free survival, objective response rate and adverse events were extracted. A meta-analysis was performed to obtain pooled hazard ratios (HR) and corresponding 95% confidence intervals (CI) for time-to-event data and pooled odds ratio (OR) with 95% CI for dichotomous outcomes. RESULTS: The meta-analysis included four randomized clinical trials with 2074 patients. The pooled results showed significant improvement for overall survival (HR = 0.87 (95% CI 0.79-0.95), p = 0.004) when necitumumab was added to chemotherapy in patients with advanced NSCLC. No statistically significant improvement was noted for progression-free survival and objective response rate (HR = 0.83 (95% CI 0.69-1.01), p = 0.06 and OR = 1.46 (95% CI 0.90-2.38), p = 0.13, respectively). Subgroup analysis showed that in patients with non-squamous NSCLC, there was no benefit in overall survival and objective response rate. Patients with advanced NSCLC who received necitumumab were at the highest odds of developing a skin rash (OR = 14.50 (95% CI 3.16-66.43), p = 0.0006) and hypomagnesaemia (OR = 2.77 (95% CI 2.23-3.45), p < 0.00001), while the OR for any grade ≥3 adverse event was 1.55 (95% CI 1.28-1.87, p < 0.00001). CONCLUSIONS: The addition of necitumumab to standard chemotherapy in a first-line setting in patients with stage IV NSCLC results in a statistically significant improvement in overall survival, while the results were not significant for progression-free survival and objective response rate.

Psychometric Properties of the World Health Organization's Quality of Life (WHOQOL-BREF) Questionnaire in Medical Students.

Background and Objectives: Studies on the effects of studying on a medical student's quality of life are sparse. The World Health Organization Quality of Life (WHOQOL-BREF) questionnaire is a widely used scale that enables the assessment and international comparisons of the quality of life. The aim of this study was to evaluate psychometric properties of the WHOQOL-BREF questionnaire among Serbian medical students. Material and Methods: We conducted a cross-sectional study that involved 760 medical students at a state medical faculty at the University of Kragujevac, Serbia. The reliability of the WHOQOL-BREF was evaluated using Cronbach's alpha coefficient and test-retest analysis, and the validity was examined using principal component analysis, with Promax rotation method. Results: Cronbach's alpha coefficient for the whole WHOQOL-BREF scale was 0.896. Internal reliability for all domains was above 0.70, except for the domain "Social Relationships" (0.533). The test-retest reliability for all domains was significant at p 0.01 level, showing good stability of the scale. Principal component analysis with Promax rotation method indicated four main components that explained 49.5% of variance. Conclusion: The Serbian version of the WHOQOL-BREF scale showed satisfactory psychometric properties that facilitate estimation of the quality of life of medical students.

Pain, Physical Function, Radiographic Features, and Quality of Life in Knee Osteoarthritis Agricultural Workers Living in Rural Population.

Background: The aim of this study was to analyse the relationship between the clinical manifestations, disease severity based on radiography images, functional activity level, and quality of life in patients with knee osteoarthritis in a rural population living in Serbian enclaves in Kosovo, as well as to determine the correlation between the WOMAC and the EQ-5D questionnaire in this population. Method: The cross-sectional study was conducted at the Internal Medicine Clinic, Clinical Hospital Center Pristina-Gracanica, located in Laplje Selo from February to December 2013. One hundred patients with confirmed (American College of Rheumatology criteria) knee osteoarthritis completed the EQ-5D and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaires, rated pain on a visual analogue scale (VAS), and underwent knee radiographic examinations. Result: Most patients were obese with moderate radiographic changes according to the Kellgeren-Lawrence scale and suffered from very severe pain according to the VAS scale. The duration of disease significantly correlated with the WOMAC scores, VAS score, and all of the scores on the EQ-5D, except for mobility. The age of participants showed a similar correlation with the same variables. The patients with higher Kellgren-Lawrence scores (3-4) were significantly older, with a significantly higher body mass index (BMI) and longer duration of disease than patients with lower scores (1-2). Significantly higher VAS, pain/discomfort EQ-5D, and WOMAC pain and function scores were also recorded among patients with more significant radiological changes. The correlations between WOMAC and EQ-5D were satisfactory. Conclusion: The severity of clinical manifestations and radiographic area changes may affect functional ability and the quality of life in knee OA patients living in rural areas, which requires adequate treatment and physical therapy.

Myocardial infarction and alcohol consumption: A case-control study.

BACKGROUND: Although epidemiological evidence for the beneficial effect of low alcohol consumption on myocardial infarction is strong, the impact of heavy drinking episodes is less clear. OBJECTIVES: The aim of this study was to investigate a possible association between the risk for acute myocardial infarction occurrence and alcohol consumption. METHODS: Our hospital-based case-control study comprised 374 participants (187 newly diagnosed patients with myocardial infarction and 187 controls, individually matched by gender, age, and place of residence). This study was performed in Kragujevac (a city in Serbia) during 2010. Logistic regression analysis was used to determine odds ratio (OR) with 95% confidence intervals (95% CI). RESULTS: The history of alcohol consumption in patients with acute myocardial infarction and their controls did not differ significantly: the percentage of those that were consuming alcohol was slightly higher in cases (54.5%) than in controls (50.3%). The habit of binge drinking during the previous 12 months was significantly more common in cases (25.1%) than in controls (12.8%): adjusted OR = 2.2 (95%CI = 1.2-4.2, p = 0.017), p for trend = 0.015. Analysis of binge drinking by age, gender and place of residence revealed that the increase in risk for acute myocardial infarction was associated with older age (adjusted OR = 5.1, 95%CI = 1.7-15.1, p for trend = 0.010), male gender (adjusted OR = 2.3, 95%CI = 1.1-5.2, p for trend = 0.028) and rural place of residence (adjusted OR = 4.8, 95%CI = 1.3-18.5, p for trend = 0.033). CONCLUSION: Our results suggest that binge drinking is associated with twice the risk for myocardial infarction compared to not drinking. Since consumption of alcohol is very common in the Serbian population, the effect of binge drinking on myocardial infarction should be considered an important public health issue.

Psychosocial Stress and Risk of Myocardial Infarction: A Case-Control Study in Belgrade (Serbia).

BACKGROUND: The purpose of this study was to investigate which psychosocial risk factors show the strongest association with occurrence of myocardial infarction (MI) in the population of Belgrade in peacetime, after the big political changes in Serbia. METHODS: A case-control study was conducted involving 154 consecutive newly diagnosed patients with MI, and 308 controls matched by gender, age, and place of residence. RESULTS: According to conditional logistic regression analysis, after adjustment for conventional coronary risk factors, the odds ratios (95% confidence intervals) for work-related stressful events, financial stress, deaths and diseases, and general stress were 3.78 (1.83-7.81), 3.80 (1.96-7.38), 1.69 (1.03-2.78), and 3.54 (2.01-6.22), respectively. Among individual stressful life events, the following were independently related to MI: death of a close family member, 2.21 (1.01-4.84); death of a close friend, 42.20 (3.70-481.29); major financial problems, 8.94 (1.83-43.63); minor financial problems, 4.74 (2.02-11.14); changes in working hours, 4.99 (1.64-15.22); and changes in working conditions, 30.94 (5.43-176.31). CONCLUSIONS: During this political transition period , stress at work, financial stress, and stress in general as they impacted the population of Belgrade, Serbia were strongly associated with occurence of MI.

Validation and cross-cultural adaptation of the questionnaire ThyPRO in thyroid patients in Serbia.

UNLABELLED: BACKGRAUND/AIM: The Thyroid Specific Patient Reported Outcome Measure (ThyPRO) questionnaire is self-administered and intended to measure quality of life of thyroid patients. The aim of this study was to investigate the validity and reliability of the translated new, ThyPRO questionnaire in Serbian patients with thyroid disease. METHODS: The translation process followed an internationally accepted methodology. The questionnaire was validated in 100 consecutive thyroid patients hospitalized in a tertiary level hospital, between April and August 2012. Internal reliabilities of ThyPRO scales were assesessed using Cronbach's α coefficient. Association between age, gender, education, marital and employment status, place of living, diagnosis, current treatment, hormonal status and patient quality of life were determined using Pearson's (r) and Spearman's (q) correlation coefficients. RESULTS: Internal consistency and reliability for ThyPRO scales were satisfactory. Cronbach's α coefficients of 13 multi-item scales of the ThyPRO were > 0.83 (range 0.83-0.95). The scores, obtained by this questionnaire, correlated significantly with patients gender, employment status, diagnosis, current treatment and place of living. A highly significant inverse relationship was found between scores and hormonal status as well as between scores and disease duration. Patients' age, marital status and thyroid-stimulating hormone level did not influence any scale score. CONCLUSION: The ThyPRO may be useful in measuring health-related quality of life in patients with thyroid disease in Serbia.

Quality of life improvement in patients with Hashimoto thyroiditis and other goiters after surgery: A prospective cohort study.

INTRODUCTION: Hashimoto thyroiditis (HT) and other benign goiters (BG) might influence patients' quality of life (QoL). The objective of this study was to analyze influence of surgery on these patients' QoL. METHODS: A prospective cohort study was conducted. The ThyPRO questionnaire was used in the QoL assessment. RESULTS: The HT patients experienced significantly worse hypothyroid symptoms and sex life than the BG patients. The improvement in QoL in the BG patients was significant after surgery in all ThyPRO domains. In the HT patients, the improvement was significant in all but two domains, eye symptoms and cognitive impairment. The best improvement in both groups was in overall QoL. None of the patients developed permanent consequences. CONCLUSIONS: The QoL of HT and BG patients is impaired and improves significantly after surgical treatment. Thyroidectomy should be considered as a treatment option in the HT patients more often as in the BG patients.

Retrospective evaluation of the incidental finding of 403 papillary thyroid microcarcinomas in 2466 patients undergoing thyroid surgery for presumed benign thyroid disease.

BACKGROUND: The aim of our study was to investigate the incidence of papillary thyroid microcarcinoma (PTMC) in patients operated for benign thyroid diseases (BTD) and its relation to age, sex, extent of surgery and type of BTD. METHODS: Retrospective study of 2466 patients who underwent thyroid surgery for BTD from 2008 to 2013. To determine independent predictors for PTMC we used three separate multivariate logistic regression models (MLR). RESULTS: There were 2128 (86.3%) females and 338 (13.7%) males. PTMC was diagnosed in 345 (16.2%) females and 58 (17.2%) males. Age ranged from 14 to 85 years (mean 54 years). Sex and age were not related to the incidence of PTMC. The overall incidence of PTMC was 16.3%. The highest incidence was in Hashimoto thyroiditis (22.7%, χ(2) = 10.80, p < 0.001); and in patients with total/near-total thyroidectomy (17.7%, χ(2) = 7.05, p < 0.008). The lowest incidence (6.6%, χ(2) = 9.96, p < 0.001) was in a solitary hyperfunctional thyroid nodule (SHTN). According to MLR, Hashimoto thyroiditis (OR 1.54, 95% CI 1.15-2.05, p < 0.003) and SHTN (OR 0.43, 95% CI 0.21-0.87, p < 0.019) are independent predictors. Since the extent of surgery was an independent predictor (OR 1.45, 95% CI 1.10-1.92, p = 0.009) for all BTD, and sex and age were not; when the MLR model was adjusted for them, Graves disease (OR 0.72, 95% CI 0.53-0.99, p < 0.041) also proved to be an independent predictor. CONCLUSIONS: Sex and age are not statistically related to the incidence of PTMC in BTD. The incidence of PTMC is higher in Hashimoto thyroiditis and patients with total/near-total thyroidectomy; and lower in patients with a SHTN and Graves disease.

Improved quality of life in hyperthyroidism patients after surgery.

BACKGROUND: The most common causes of hyperthyroidism are Graves disease (GD) and toxic nodular goiter (TNG). GD and TNG might influence patients' quality of life (QoL). The aim of our study was to analyze and compare the QoL of patients with GD with that of TNG patients and to evaluate the influence of surgical treatment on their QoL. MATERIALS AND METHODS: A prospective case-control study was conducted at the Center for Endocrine surgery in Belgrade, Serbia. The ThyPRO questionnaire was used in the QoL assessment of the GD and TNG patients (31 and 28, respectively) pre- and post-operatively. RESULTS: All patients were receiving antithyroid drugs, and none of the patients were overtly hyperthyroid at the time of completing the preoperative questionnaire. The QoL of the GD patients was worse than that of the TNG patients, with significant differences in eye symptoms, anxiety, and sex life domains (P < 0.001, P = 0.005, and P = 0.004, respectively), preoperatively, and in eye symptoms, anxiety, emotional susceptibility, and overall QoL (P = 0.001, P = 0.027, P = 0.005 and P = 0.013, respectively), postoperatively. The improvement in QoL in the GD patients was significant after surgical treatment in all ThyPRO domains. In the TNG patients, the improvement was significant in all but one ThyPRO domain, sex life (P = 0.066). CONCLUSIONS: The QoL of GD patients is worse than those of TNG patients. Surgery may improve QoL in patients with GD and TNG even if they have achieved satisfying thyroid status with medication treatment, preoperatively.

Age as a prognostic factor in anaplastic thyroid cancer.

Background. Anaplastic thyroid cancer (ATC) is one of the tumors with the shortest survival in human medicine. Aim. The aim was to determine the importance of age in survival of patients with ATC. Material and Methods. We analyzed the data on 150 patients diagnosed with ATC in the period from 1995 to 2006. The Kaplan-Meier method and log-rank test were used to determine overall survival. Prognostic factors were identified by univariate and multivariate Cox regression analysis. Results. The youngest patient was 35 years old and the oldest was 89 years old. According to univariate regression analysis, age was significantly associated with longer survival in patients with ATC. In multivariate regression analysis, patients age, presence of longstanding goiter, whether surgical treatment is carried out or not, type of surgery, tumor multicentricity, presence of distant metastases, histologically proven preexistent papillary carcinoma, radioiodine therapy, and postoperative radiotherapy were included. According to multivariate analysis, besides surgery (P = 0.000, OR = 0.43, 95% CI = 0.29-0.63), only patients age (P = 0.023, OR = 0.68, 95% CI = 0.49-0.95) was independent prognostic factor of favorable survival in patients with ATC. Conclusion. Age is a factor that was independently associated with survival time in ATC. Anaplastic thyroid cancer has the best prognosis in patients younger than 50 years.

Improvement of quality of life in patients with benign goiter after surgical treatment.

PURPOSE: A quality of life (QoL) assessment is considered an important outcome measure in the treatment of benign thyroid diseases. The aims of this study were to analyze the impact of different surgical treatments on QoL in patients with benign thyroid diseases and to evaluate factors correlating with the QoL outcomes. METHODS: A prospective longitudinal study was conducted. One hundred thirty-two patients met the inclusion/exclusion criteria and completed the disease-specific questionnaire, thyroid patient-reported outcome (ThyPRO), before surgery and after 6 months. Preoperative and postoperative QoL outcomes were compared and correlating factors were analyzed. RESULTS: Indication for surgery was euthyroid goiter, toxic goiter, and suspicious malignant thyroid disease in 58.3, 29.5, and 12.1 % of the patients, respectively. None of the patients had overtly toxic goiter. There were 65.2 % of the patients who underwent total thyroidectomy, while 34.8 % underwent hemithyroidectomy. The total postoperative complication rate was 5.3 %. QoL improved significantly after surgical treatment, independent of the extent of performed surgery. The most affected domain, pre- and postoperative, was for tiredness. QoL improvement was significant for women in all domains, while for men, it was significant in only three domains (goiter symptoms, emotional susceptibility, and cosmetic complaints) and in overall QoL. Younger patients had significantly better cognitive functioning and daily life, while elderly patients had significantly less cosmetic complaints. The factors that significantly correlated with improvement of QoL in different domains were lower education level, duration of disease, and microcarcinoma at final histology. CONCLUSION: QoL in patients with benign thyroid diseases improves significantly after operative treatment, independent of the extent of the operation.

A survey of female students with migraine: what is the influence of family history and lifestyle?

OBJECTIVES: To compare characteristics of migraine and some lifestyle habits in migraineurs with and without a positive family history for migraine. METHOD: The prevalence study was combined with a case-control study and comprised 245 female students with migraine. RESULTS: Out of 245 female students with migraine, 132 (53.9%) had a positive family history for migraine. In comparison with migraineurs who had not, those with a positive family history were younger at the onset of migraine and significantly more frequently reported menstrual migraine (p < 0.001), unilateral pain (p < 0.05) and pulsate pain (p < 0.05) as well as severe headache (p < 0.01). In comparison to migraineurs with a positive family history for migraine, those who did not report a significantly higher frequency of average number of meals per day of <3 (p < 0.001), missed meals (p < 0.05) and an average sleep duration of ≤ 6 h (p < 0.05). CONCLUSIONS: The results of the present study are in line with literature showing a high frequency of positive family history for migraine among migraineurs. They also suggest that subjects with a positive family history have a lower "migrainous threshold" for the development of migraine and that environmental factors are more important for the occurrence of migraine in subjects without a positive family history. Accordingly, the conclusions of this study are limited to reproductive aged women.

Trends in mortality rates from coronary heart disease in Belgrade (Serbia) during the period 1990-2010: a joinpoint regression analysis.

BACKGROUND: Coronary heart disease (CHD) causes an estimated 7 million deaths worldwide each year. In the last few decades, mortality from CHD has been decreasing in many countries. The aim of this study was to analyze the trends of mortality from CHD and myocardial infarction (MI) in the population of Belgrade during the period 1990-2010. METHODS: Mortality data for CHD and MI were obtained from the Municipal Institute of Statistics in Belgrade and used to calculate age- and sex-specific and age-adjusted mortality rates. Joinpoint regression analysis was used to estimate annual percent changes (APCs) in mortality and to identify points in time where significant changes in trend occur. RESULTS: Trends in CHD mortality rates showed significant decline in men during the period studied (APC -0.5%, no joinpoints detected), but no significant change among women (APC +0.4%, no joinpoints detected). While we observed significant declines in CHD mortality in men aged 35-44, 55-64 and 65-74 and women aged 55-64, there was a significant increase in mortality in men aged ≥85 and women aged 75-84 and ≥85. Trends in MI mortality rates showed similar patterns in both genders, with a significant decline from the mid-1990s. Significant decline in MI mortality was observed in almost all age groups, except the two oldest (75-84 and ≥85) in women population. CONCLUSIONS: Given that CHD and MI mortality trends showed different patterns during the period studied, especially in women, our results imply that further observation of trend is needed.

Risk factors for well-differentiated thyroid cancer in men.

AIMS AND BACKGROUND: Thyroid cancers are relatively rare tumors that appear more frequently in women than in men. Accordingly, most studies focus on studying risk factors for thyroid cancer in women and consequently on various hormonal or reproductive factors that are specific for women. The aim of our study was to examine risk factors for developing well-differentiated thyroid cancer in men. Heretofore, we did not encounter in the literature a study that was solely focused on studying risk factors for well-differentiated thyroid cancer in men. METHODS: A case-control study was performed from 2005 to 2010. The case group included 204 consecutive well-differentiated thyroid cancers in male patients (180 papillary and 24 follicular including Hürthle cell). The control group comprised the same number of cases. Patients were individually matched by gender, age and place of residence. Statistical analysis included conditional univariate and multivariate logistic regression methods. RESULTS: According to univariate logistic regression, well-differentiated thyroid cancer in men was significantly related to smoking status, duration of smoking, number of cigarettes smoked per day, history of goiter or thyroid nodules, history of non-thyroid cancer, diabetes mellitus, radiotherapy of the head and neck, and history of malignant tumors. According to multivariate logistic regression, it was independently related to smoking status (OR = 0.36; 95% CI, 0.19-0.69), history of goiter or thyroid nodules (OR = 9.19; 95% CI, 1.25-64.58), and a history of malignant tumors (OR = 2.11; 95% CI, 1.19-7.33). CONCLUSIONS: Risk factors for well-differentiated thyroid cancer in men were goiter or thyroid nodules and family history of malignant tumors. Cigarette smoking was negatively associated with the disease.

Fixed drug eruption caused by tadalafil--case report.

UNLABELLED: Fixed drug eruptions (FDE) are commonly reported type of mucocutaneous drug eruption. The aim of this paper is to present a patient with multiple mucocutaneous erythema fixum type lesions caused by oral tadalafil use. A short course of topical corticosteroid therapy resulted in complete resolution of all lesions leaving residual hyperpigmentation of the involved skin sites. Mucosal oral lesions were effectively treated with gingival hyaluronic acid 0.2% gel. CONCLUSION: when assessing a patient of any age with drug eruptions, a thorough personal history should be obtained, in particular data on regular or recreational use of phospodiesterase type 5 inhibitors.