CHRONIC MULTIMORBIDITY OF LOW BACK PAIN OR OTHER CHRONIC BACK DISORDERS IN THE REPUBLIC OF CROATIA.

The aim was to assess the prevalence of chronic multimorbidity in patients with chronic low back pain or other chronic back disorders (BD). We analyzed data from the population-based cross-sectional European Health Interview Survey (EHIS) performed in the Republic of Croatia 2014-2015 by the Croatian Institute of Public Health. Outcome was the point-prevalence of chronic multimorbidity defined as having ≥2 chronic illnesses out of 14 contained in the EHIS questionnaire, after adjustment for ten sociodemographic, anthropometric and lifestyle confounders. Amoung fourteen targeted illnesses were asthma, allergies, hypertension, urinary incontinence, kidney diseases, coronary heart disease or angina pectoris, neck disorder, arthrosis, chronic obstructive pulmonary disease, diabetes mellitus, myocardial infarction, stroke, depression, and the common category "other". We analyzed data on 268 participants with BD and 511 without it. Participants with BD had a significantly higher relative risk of any chronic multimorbidity (RRadj=2.12; 95% CI 1.55, 2.99; p<0.001), as well as of non-musculoskeletal chronic multimorbidity (RRadj=2.29; 95% CI 1.70, 3.08; p=0.001) than participants without BD. All chronic comorbidities except for asthma and liver cirrhosis were significantly more prevalent in participants with BD than in participants without BD. In the population with BD, the participants with multimorbidity had three to four times higher odds for unfavorable self-reported health outcomes than the participants with no comorbid conditions, whereas the existence of only one comorbidity was not significantly associated with a worse outcome compared to the population with no comorbidities. In conclusion, the population suffering from BD has a higher prevalence of chronic multimorbidity than the population without BD and this multimorbidity is associated with unfavorable health outcomes.

The heterogeneity of population with high risk for melanoma and other skin cancer: a latent class analysis.

OBJECTIVE: To examine whether there is heterogeneity in the risk factors for skin cancer among the high-risk population in Slovenia, a Central European country with the second-largest age-standardized melanoma-related mortality rate in Europe. METHODS: We analyzed data collected during the 'Euromelanoma Day' 2010-2019. The outcome was the prevalence of newly suspected skin cancer. The independent variables were 17 known risk factors and protective behaviors. We performed a latent class analysis with skin cancer as a covariate. RESULTS: We analyzed data from 1711 participants with a median (interquartile range) age of 52 (39-63) years, 52% of whom were women. During the 10 years, 81 cases of melanoma and 213 cases of other skin cancers were suspected. The model with three latent classes had the best fit. Two latent classes had a high risk for melanoma and other skin cancer: 3 and 19% respectively in class 2; 14 and 29% in class 3. The largest significant differences between the two high-risk classes were the older age and lower frequency of sunscreen use in high-risk class 2 and the number of atypical nevi, a large number of common moles, many moles as the primary motive to participate in Euromelanoma examination and having a skin phototype I or II in the highest-risk latent class 3. CONCLUSIONS: There is heterogeneity in the risk factors for skin cancer among the Euromelanoma high-risk population. This heterogeneity should be tested in other countries, and if the findings are consistent, they should be used to refine secondary prevention programs.

Effectiveness and safety of hyaluronic acid fillers used to enhance overall lip fullness: A systematic review of clinical studies.

BACKGROUND: The majority of aesthetic treatments today are nonsurgical or minimally invasive aesthetic procedures. Soft-tissue augmentation with hyaluronic acid (HA) is one of them. Lip fullness and definition are key aesthetic factors associated with attractiveness, which is the reason that lip augmentation with HA fillers has become so popular. OBJECTIVE: To provide a systematic review of published medical literature on the effectiveness and safety of different HA fillers used to enhance overall lip fullness. METHODS AND MATERIALS: The literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Twenty-two studies were included in the qualitative synthesis, 9 of them with level of evidence (LOE) 1b (randomized controlled trials), 1 with LOE 2b (individual cohort study), and 12 with LOE 4 (case series, poor-quality cohort, and case-control studies). A total number of subjects included in all studies were 3965. RESULTS: Hyaluronic acid fillers turned out to be an effective and safe treatment. The assessment methods (especially for efficacy) varied greatly from one study to another. Observed responses to the treatment in studies using different lip fullness scales varied between 71% and 93.2%. The most common adverse events were local reactions at the injection sites (swelling, contusion, bruising, pain, redness, and itching). CONCLUSION: Based on the results of the studies included in this systematic review, HA fillers are effective and safe to use. The majority of included subjects were satisfied with the result and their looks.

Melanocytic lesions with eczematous reaction (Meyerson's phenomenon) - a histopathologic analysis of 64 cases.

BACKGROUND: Eczematous (spongiotic) reaction in melanocytic lesions (Meyerson's phenomenon) has not been systematically analyzed and has not been convincingly documented in melanoma. METHODS: We analyzed 64 consecutive melanocytic lesions with spongiotic reaction, occurring in 57 patients (age range 14-81 years; mean, 39 years; 30 females, 27 males) including 16 common acquired nevi, 3 nevi with congenital features, 2 Spitz nevi, 29 dysplastic nevi, 6 in situ and 8 invasive melanomas. RESULTS: The intensity of the spongiotic reaction was graded as mild in 24 (38%), moderate in 22 (34%) and marked in 18 (28%) lesions. It was moderate/marked in 6 of 14 (43%) in situ or invasive melanomas. Upward migration of melanocytes in the epidermis was noted in 7 (33%) non-dysplastic and 10 (34%) dysplastic nevi but was generally limited to the lower half of the epidermis. Moderate/severe cytologic atypia was found in 14 (48%) dysplastic nevi and all melanomas but not in non-dysplastic nevi. CONCLUSIONS: Prominent spongiotic reaction with eosinophils in the inflammatory infiltrate can affect all types of melanocytic lesions. Upward migration involving the uppermost layers of the epidermis, especially when extensive and present in areas with a less pronounced spongiotic reaction, and moderate/severe cytologic atypia indicate a melanoma.

Thorough clinical evaluation of skin, as well as oral, genital and anal mucosa is beneficial in lichen planus patients.

Lichen planus (LP) is a common mucocutaneous disease of unknown aetiology with various geographical prevalence, may be related to some serious disorders such as squamous cell carcinoma and often remains underdiagnosed. The aim of this retrospective study was to thoroughly determine localization and clinical characteristics of LP lesions in a cohort of 173 Slovenian patients in association to the presence of accompanying symptoms and history of potential stressful events. Isolated cutaneous lesions of LP were found in 56.6% and isolated oral LP in 3.5% of patients. Thirty-four percent presented orocutaneous LP, whereas genitocutaneous LP was noted in 1.2%, orogenito-cutaneous LP in 4% and orogenital LP in 0.5% of patients. Underlying stressful events were noted in 36 out of 137 (26.3%) patients. Despite obviously visible localization of the lesions various medical specialists should be familiar with LP and thoroughly examine the complete skin, as well as oral, genital and anal mucosa in each LP patient to avoid a delay in diagnosing this disease and possibly disclose a much serious underlying condition. Psychological support should be offered, if needed.

Lack of evidence for hepatitis C virus infection in association with lichen planus.

BACKGROUND: The association between hepatitis C virus (HCV) infection and lichen planus (LP) is a subject of controversy. Prevalence studies of HCV infection in LP patients in various countries reveal diverse results. The Slovenian population is rather homogenous with specific geographic and epidemiological characteristics. Lack of data or contradictory results from neighboring countries urged the need for a case-controlled study in our LP patients. METHODS: The retrospective study was performed on 173 LP patients. Control group included 218 patients with dermatological diseases other than LP. RESULTS: Anti-HCV antibodies were found in 2/173 patients (1.2%) with LP and in 0/218 controls. No statistically significant difference was found between the study and control group regarding anti-HCV antibody prevalence (P = 0.195; estimated OR 6.4, 95% CI 0.3-134.0) and risk factors for HCV infection. CONCLUSIONS: Based on our results, anti-HCV antibody testing is not necessarily required in LP patients with no risk factors for HCV infection in this geographic region.