Men Average Age Research Articles

Incidence rate and clinical characteristics of seasonal affective disorders in senior medical students

Aim. To study the incidence rate, clinical features, and prognosis of seasonal affective disorder (SAD) in senior (6th-year) medical students.Materials and methods. SAD screening using the Seasonal Pattern Assessment Questionnaire (SPAQ, 1987) included 119 undergraduate medical students. 78 students were females (65.5%) and 41 – males (34.5%) (p = 0.001). The average age of women was 23 (22; 23) years, the average age of men – 23 (22; 24) years. Statistical processing was performed using the Mann – Whitney U-test, Pearson’s χ2 test, and Spearman’s rank correlation coefficient (rs).Results. The data on the prevalence of affective disorders with a seasonal pattern in medical students were obtained: SAD – 9.2%, sub-SAD – 13.5%, psychological undulation of season perception (PUSP) – 16.8%. The number of students who did not exhibit seasonal undulation of the six main characteristics recorded by the SPAQ was 72 (60.5%) (p = 0.001). There were statistically significant differences in the higher median Global Seasonality Score of the SPAQ for SAD compared with PUSP, both with and without account of the gender factor (p = 0.001). The use of a binary logistic regression model made it possible to identify groups of students with or without SAD according to the SPAQ. The data obtained determined the contribution of the following factors: gender, seasonality, body weight, and the number of sleep hours per day in spring.Conclusion. The study made it possible to obtain a logistic regression model that allowed to predict the greatest likelihood of developing SAD.

Prevalence of lesions and risk factors in patients with lower extremities atherosclerosis referred for surgical intervention: gender differences

Background. Atherosclerotic disease of the arteries of the lower extremities or peripheral arterial disease (PAD) affects both men and women. PAD can be combined with the damage of other vascular regions, which is defined as multifocal atherosclerosis (MFA) and suggests the most severe course of the disease and an unfavorable prognosis of patients. The high risk of cardiovascular complications determines the importance of active secondary prevention in patients with PAD and MFA. Data on the frequency of MFA, characteristics of risk factors (RF) and their treatment depending on gender are limited in the literature.Objective. To study the prevalence of atherosclerotic lesions, RF for atherosclerosis and their treatment at out-patient stage in men and women with PAD referred for surgical treatment. Design and methods. According to medical records analyzed the results of a survey of 65 men and 26 women consecutively admitted to the department of cardiosurgery of the Almazov National Medical Research Center from January 2018 to January 2019 for surgical treatment. All patients underwent duplex scanning (DS), X-ray or CT-angiography of the arteries of the lower extremities, 49 patients underwent coronary angiography, and 72 patients underwent DS or CT-angiography of the brachiocephalic arteries (BCA).Results. The average age of men and women did not differ significantly. The most common RF were hypertension and current smoking or the PAD. Smoking was observed less frequently in women. Data on lipid profile were available in 62 patients (68 %), the level of low-density lipoproteins (LDL) was determined in 22 subjects (24 %). The incidence of dyslipidemia and diabetes mellitus did not differ significantly in both groups, however, fasting hyperglycemia was found in 9 women without diabetes mellitus (50 %). The target LDL level was achieved only in 3 men. Two or more RF were detected in 87 % of patients; the groups of men and women did not differ in the number of RF. Signs of involvement of one arterial region were found in 18% of patients, two regions — in 48%, three regions — in 28% without differences in men and women (p > 0,05). In combination with PAD, men were more likely to have coronary artery (CA) disease than women (p < 0,05); the incidence of BCA lesions did not differ significantly (p = 0,02). Women less often, although not significant, received statins (69% versus 84%), beta-blockers (46% versus 66%), antiplatelet agents (77 % versus 84,6%).Conclusions. Both men and women hospitalized for surgical treatment of PAD have multiple RF of comparable frequency, with the exception of smoking. Regardless of gender, the majority of patients show signs of MFA with predominant CA disease in men. The absence of significant differences in the number of RF and the frequency of MFA in men and women may be associated with the presence of comparable severe clinical manifestations of PAD, which determine the indications for revascularization of the lower extremities. The evaluation of patients is inadequate: not all patients have controlled cholesterol and LDL levels, tests are not performed in women with fasting hyperglycemia to exclude diabetes mellitus and prediabetes. There is a clear trend towards less active secondary prevention in women.

Дефіцит та недостатність вітаміну D серед населення Львівської області

Вітамін D є одним з важливих метаболітів організму людини, що має широкий спектр дії та є корегулятором багатьох важливих фізіологічних процесів. Метою дослідження було вивчити частоту дефіциту та недостатності вітаміну D серед населення Львівської області та встановити чинники, що на них впливають. Матеріали і методи. Було обстежено 227 практично здорових осіб віком 20–85 років. Середній вік чоловіків — 52,79 ± 14,44 року, а жінок — 51,12 ± 13,72 року (р > 0,05). Дослідження проходили в червні протягом 2009–2011 років. Спостереження проводилися в трьох географічних зонах Львівської області: лісовій, передгірній та гірській. Рівень 25(ОH)Dtotal у сироватці крові визначали за допомогою електрохемілюмінесцентного методу на аналізаторі Eleсsys 2010 (Roche Diagnostics, Німеччина) тест-системами cobas. Результати. У Львiвськiй області дефіцит вітаміну D реєструється у 50,7 % жителів, а недостатність — у 33,0 %. В обстежених віком 70–79 років реєструються вірогідно нижчі показники 25(ОН)D у сироватці крові (14,31 ± 7,81 нг/мл) порівняно з віковою групою 20–29 років (21,72 ± 12,63 нг/мл, р < 0,05), 30–39 років (22,49 ± 10,39 нг/мл, р < 0,001), 50–59 років (22,02 ± 8,73 нг/мл, р < 0,0001) та 60–69 років (19,84 ± 10,00 нг/мл, р < 0,05). Встановлено, що вік має вірогідний негативний слабкий вплив на рівень 25(ОН)D у сироватці крові (r = –0,17, p = 0,01). Висновки. Проведені дослідження не виявили впливу статі, індексу маси тіла та географічного положення району проживання на середній рівень 25(ОН)D у сироватці крові у жителів Львівської області.

Клинико-гормональная характеристика больных с гигантскими образованиями хиазмально-селлярной области

Цель исследования: изучить клинико-гормональную характеристику пациентов с гигантскими образованиями хиазмально-селлярной области. Материал и методы. За период с 2015 по 2016 г. обследовано 35 взрослых больных с макроаденомами гипофиза, из них 48,6 % мужчин. Средний возраст мужчин составил 37,12 года, женщин — 38,15 года. Давность заболевания колебалась в пределах от 2 месяцев до 25 лет. Результаты. Распределение больных по топографо-анатомической классификации стороны роста аденомы гипофиза показало, что наиболее часто наблюдались аденомы гипофиза с тотальным вариантом роста (51,4 %). У больных с гигантскими аденомами гипофиза наиболее часто встречались пангипопитуитаризм (44,4 %), а также битемпоральная гемианопсия (61,1 %) и вторичная аменорея (33,3 %). Такие нарушения, как вторичная остеопения, эндокринная энцефалопатия, задержка физического и полового развития, были выявлены только в этой группе больных. Кроме того, достоверное снижение средних значений базальных уровней тропных гормонов гипофиза (соматотропный гормон (СТГ), лютеинизирующий гормон (ЛГ), фолликулостимулирующий гормон (ФСГ), адренокортикотропный гормон) было зафиксировано у пациентов с гигантскими аденомами гипофиза. Выводы. У больных с гигантскими аденомами гипофиза в первую очередь отмечается снижение уровня СТГ, ФСГ, ЛГ. Наиболее выраженные нейроэндокринные и офтальмологические нарушения встречаются у больных с гигантскими аденомами гипофиза.

OCT ANGIOGRAPHY AND DOPPLER ULTRASOUND IN HYPERTENSION GLAUCOMA.

The main aim of this work was to find out if there is acorrelation between vessel density (VD) and results of measured perfusion values in ophthalmic artery and in central retinal artery of the same eye in agroup with hypertension glaucoma (HTG). The file included 20 patients with HTG, thereof 13 women of average age 68.7 years (49-80 years) and 7 men of average age 58.4 years (27-81 years). Criteria for inclusion in the study: visual acuity 1,0 with possible correction less than ±3 diopters, approximately the same changes in visual fields in every patient, intraocular pressure (IOP) less than 18 mmHg, no other ocular or neurological diseases. VD was measured by Avanti RTVue XR by Optovue firm, perfusion parameters were measured using Doppler ultrasound with Affinity 70G machine by Philips firm. The peak systolic velocity (PSV) and end diastolic velocity (EDV) and resistance index (RI) were measured both in ophthalmic artery (AO) and in central retinal artery (CRA). Visual field (VF) was examined by quick threshold glaucoma program by Medmont M 700 machine. The sum of sensitivities in apostilbs (abs) was evaluated in the range 0-22 degrees of visual field. The results of sensitivities in visual field were compared to VD and perfusion parameters in CRA and AO of the same eye. Pearsonscorrelation coefficient (p=0,05) was used to assess the dependency between chosen parameters. By comparing VF and VD from measured areas, strong correlation (r=0.64, resp. 0.65) was revealed. It was then proved that VD (WI-VDs) correlates with RICRA weakly (r=-0.35) and moderately strongly (WI-VDa r=-0.4, PP-VDs r=-0.43 and PP-VDa r=-0.45). This means that with increasing resistance index in CRA the density in VD decreases. The other correlations between VD and perfusion parameters (PSV and EDV) in CRA and AO were not significant. Measured values showed that the vascular component of VD has ahuge impact on the changes in visual fields in HTG. Weak to moderate influence exists between VD and RI in CRA. OCTA has proven to be more suitable than Doppler ultrasound for determining the condition of blood circulation in the eye.

PTBD During COVID-19 Pandemic: A Life Saving Procedure in Malignant Obstructive Jaundice Patients

Objective: PTBD is an important lifesaving alternative for biliary tract decompression to endoscopic drainage in the treatment of malignant obstructive jaundice patients. The aim of this study was to evaluate the usefulness of PTBD in terms of the relief of symptoms and laboratory data, survival after PTBD, and the relationship between patient characteristics and survival during COVID-19 pandemic. Methods: During this study, in total thirteen patients’ procedures of percutaneous drainage were applied during a three-month period. The average age of men was 59 years and women was 55 years. The causes of obstructive jaundice were investigated using both abdominal computed tomography and abdominal ultrasonography. Results: In examined group percutaneous drainage was successful in 92.3% (12 patients) and drainage procedure application was ineffective in 7.7% (1 patient). After PTBD, almost all the symptoms of obstructive jaundice were relieved, except in one patient. Transient haemobilia was the only complication seen in one patient. Conclusion: In present scenario of COVID-19 pandemic, PTBD emerges as an effective method of biliary tract decompression and an important alternative to endoscopic drainage. It decreased the jaundice and relieved the symptoms caused by biliary tract obstruction. Thus, our study shows a positive impact in quality of life of patients after PTBD.

Predictors Of The Development Of Chronic Kidney Disease In Patients With Chronic Obstructive Pulmonary Disease

The aim of the study was to identify predictors of decreased glomerular filtration in patients with chronic obstructive pulmonary disease (COPD). Materials and methods. We analyzed 145 case histories of patients diagnosed with COPD. The majority (84.1%, n = 122) of them are males (the average age of men is 60.7 ± 0.9 years, the average age of women is 62.0 ± 2.7 years). A comparative analysis of the prevalence of risk factors for chronic kidney disease (CKD) in patients with COPD: age, gender, smoking, arterial hypertension, overweight, etc. The glomerular filtration rate (GFR) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD – EPI) formula, according to which the patients were divided into 6 groups: group 1 - hyperfiltration, group 2 - GFR CKD – EPI ≥ 90 ml / min / 1 , 73 m2, 3rd - GFR CKD – EPI 60–89 ml / min / 1.73 m2, 4th - GFR CKD – EPI 45–59 ml / min / 1.73 m2, 5th - GFR CKD – EPI 30 - 44 ml / min / 1.73 m2 and 6th-GFR CKD-EPI <30 ml / min / 1.73 m2. Results. Patients with COPD have a high incidence of CKD risk factors. A correlation was found between the prevalence of CKD risk factors and the severity of COPD. The main predictors of the development of CKD in patients with COPD: duration of COPD> 9 years, body mass index> 26.5 kg / m2, smoking index> 51.3, albumin> 44.0 g / l, total protein> 70.0 g / L, forced expiratory volume in the first second ≤ 1.6 L, right atrial size> 35.5 mm, systolic pressure in the pulmonary artery> 36.6 mm Hg. Art., the thickness of the posterior wall of the left ventricle> 10.5 mm, Tiffno's index ≤ 62%. Conclusion. It was found that patients with COPD have a high incidence of both traditional and nonspecific risk factors for a decrease in GFR.

Genitourinary tuberculosis in the structure of autopsy morphological findings in deceased patients at the late stages of HIV infection

Introduction. The problem of tuberculosis (TB) has not lost its significance due to the overlapping epidemic of HIV infection and the addition of specific lesions at its late stages. It is due to the lack of adherence to antiretroviral therapy in a large number of patients. The high mortality rate in HIV-associated TB requires an increase in the interest of all doctors for the early detection of various TB localizations against the background of HIV, allowing the patient to be cured. For urologists, information on the frequency of genitourinary TB in HIV patients is of interest to improve its diagnosis. Purpose of the study. To identify the proportion of genitourinary TB in the structure of the specific lesions in patients with HIV-associated TB. Materials and methods. The case-records of 115 deceased patients with a combination of HIV infection and TB were retrospectively analyzed using a continuous method. The number of men among them was 81.7 ± 3.6% (94). The average age of men was 37.1 ± 27.2 years, women — 31.9 ± 6.3 years. The research results were processed statistically. Results. The average period from the moment of HIV infection detection to the registration of a lethal outcome was 2.8 ± 1.3 years, from the moment of TB diagnosis — 6.96 ± 7.3 years. The majority of patients with HIV infection had a stage of secondary diseases (93.1 ± 2.4%). At the time of admission to the TB dispensary, the average CD4 + lymphocyte level was 131.06 ± 75.8 cells/pL, 10.03 ± 2.5%. Anti-retroviral therapy was observed only in 19 (16.5 ± 3.5%) patients. In deceased patients disseminated pulmonary TB was more often verified at autopsy — 52.2 ± 4.7%, miliary — 7.8 ± 2.5%, infiltrative — 11.3 ± 3.0%. In patients with disseminated and miliary pulmonary TB, foci of dropout were often observed in the spleen (71.7 ± 5.8% and 55.6 ± 16.6%) and liver (46.7 ± 6.4% and 33.3 ± 15,7%). The kidney damage occurred in 60.0 ± 6.3% of patients with disseminated and 44.4 ± 16.6% miliary pulmonary TB. Kidneys TB was confirmed by bacterioscopic urine examination in three cases only (2.6 ± 1.5%) during life. Prostate TB was confirmed by analysis of expressed prostatic secretion on Mycobacterium tuberculosis (2.6 ± 1.5%) and was combined with kidney TB. The lesions of the lymphatic system during life were exposed in 17.4 ± 3.5% of patients. A pathomorphological examination revealed TB of intrathoracic lymph nodes in 37.4 ± 4.5%, intra-abdominal lymph nodes — in 22.6 ± 3.9%, peripheral — 6.1 ± 2.2%, more often in miliary and disseminated pulmonary TB. TB meningitis was registered in 31 cases as well as meningoencephalitis in 32 patients during life and at autopsy, respectively. Intestinal TB was confirmed by autopsy in 9.6 ± 2.7% of patients; during life, it was accompanied by the detection of the pathogen in the feces. The pancreatic TB was detected in 2.6 ± 1.5%, TB spondylodiscitis in 1.7 ± 1.2%, myocardial TB in 0.9 ± 0.9% and pericardium TB in 0.9 ± 0.9% cases. Conclusion. Thus, generalized TB is diagnosed in patients in the late stages of HIV infection, in the structure of which kidney damage is in second place, yielded only to spleen damage. Obtaining this information should form the alertness of urologists in terms of detecting and diagnosing genitourinary TB in patients with HIV infection.

Influence of cerebral stroke on life prognosis of patients with stable coronary heart disease according to the data of CHD PROGNOSIS registry

Objective: to assess how cerebral stroke (CS) in patient’s history affectы length life of patients with stable coronary heart disease (СHD), included in the СHD PROGNOSIS registry.Materials and methods. We analyzed the data of patients from CHD PROGNOSIS registry who underwent coronary angiography and confirmed CHD diagnosis (n = 541, including 432 men and 109 women) during the reference hospitalization in the National Medical Research Center for Therapy and Preventive Medicine of the Ministry of Health of Russia from 01 / 01 / 2004 to 31 / 12 / 2007. The average age of men and women was 57.5 ± 0.4 and 60.9 ± 0.9 years, respectively. During reference hospitalization, we took into account CS / transient ischemic attack in anamnesis (retrospective part) and frequency of reaching endpoints (general and cardiovascular mortality, myocardial infarction and CS after 4 and 7 years of follow-up (prospective part). In case of 4-year observation, therapy response was 89 %, in case of 7-year observation – 93 %.Results. Twenty (3.7 %) patients had CS or transient ischemic attack in anamnesis at reference hospitalization, 284 (52.5 %) patients suffered myocardial infarction (p < 0.001). There were revealed differences in patients with coronary artery disease, which cannot be detected in the anamnesis by age, sex, presence of comorbid burden, arterial hypertension and diabetes mellitus, non-cardiological diseases, smoking frequency. The relative risk of death from all causes at 4- and 7-year follow-up was 3.3 and 2.4 times higher, respectively (p < 0.05). Patients with CS in anamnesis demonstrated 25 and 45 % overall mortality in 4 and 7 years, their cardiovascular mortality was 25 and 35 %, respectively. Patients without CS in medical history demonstrated 9 and 18 % overall mortality after 4 and 7 years of follow-up, cardiovascular mortality was 8 and 12 %, respectively (intergroup differences are statistically significant at p < 0.05–0.01).Conclusion. It was noted that patients with CHD and CS in anamnesis were older, percent of women among them was higher, they more often suffered from grade II–III hypertension and diabetes mellitus, had more comorbidities, but smoked less often. CS in anamnesis significantly worsened the medium-term and long-term life prognosis for patients with CHD, increasing overall and cardiovascular mortality.

WITHDRAWN: Morphometric Analysis of Cavitas Glenoidalis with Multidedector CT.

Ahead of Print article withdrawn by publisher.

Evaluation of the effectiveness of the compression method for infiltration anesthesia of the mandibular molars

To study the depth of analgesia and the electrical excitability dynamics of the pulp of the tooth under local anesthesia without and with compression on the depot of local anesthetics. 87 men and 93 women took part in the study, the average age of men was 36.8±5.02 and the average age of women was 30.43±2.14. According to the indications, local anesthesia of infiltration type with and without compression at the depot of local anesthetics was performed. The injection was carried out with a solution of 4% articaine with epinephrine1:100000 or 1:200000. Patients were divided into 2 groups depending on the used concentration of the vasoconstrictor with 4% articaine. The target area thermometry and electroodontometry (EOD) of the first mandibular molar were performed. The criterion for the onset of pulp analgesia was the value from 92 to 100 mA. Dynamics of change in pulp electrical excitability of the first molar with the use of 4% articaine with epinephrine 1:200000 without a compress showed that in the latter case the reduction of pulp electrical excitability to 96.6 µA, which is optimal for painless treatment, was developed by the 5th minute of the study and remained at the limit of 92.2-92.1 µA for 20 minutes. When using 4% articaine 1:100 000 it was noted that also the compression technique allowed to reach the necessary reduction of EOD indices to 93.5 µA by the 5th minute of the study, and to 97.2 µA by the 10th minute. Increased hypothermia in the injection depot area was noted thermographically, especially when high concentrations of epinephrine were used. Our own studies reflect the dynamics of change in the electrical excitability of the pulp of the first molar with the use of 4% articaine by compression method more intensively reduces the electrical reacrivity of the dental pulp depending on the concentration of the epinephrine: with the use of 1:100000, the advantage of the pressure technique is 19.3% and 1:200000 - 21.8%.

Major Depressive Disorder and Difference between Genders.

Background:Depression is a common mental disorder and represents a global mental health concern. Presents with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy and poor concentration. Epidemiologic research have found clear genders differences in the prevalence of Major depressive disorders (MDD).Objective:The aim of this study was to find the difference in the symptoms of Major depressive disorder (MDD) between genders.Methods:It was analyzed 92 subjects from Health Center Zivinice in the period from September 2019 to May 2021, of which 57 (62 %) are women and 35 (38%) are men. The study identified and measured the severity of 25 different symptoms of depressive disorders in the analyzed subjects. The average age of women is 56 years ± 8.88, and the average age of men is 52 years ± 11.03. Statistical data were analyzed in SPSS statistical program.Results:Comparing the results t tests revealed significant difference between genders in symptoms like depressed mood, lack of energy, psychomotor retardation, pessimistic attitude towards the future. Symptoms such as angry outbursts, irritability from frustration, even over small matters, frequent or recurrent thoughts of death, suicidal thoughts suicide attempts and impulsive reaction, risky behaviour statistical significance in men in relation to women.Conclusion:In this study it was confirmed that MDD is more often diagnosed in women and showing different ways of experiencing, expressing and dealing with the symptoms of MDD. Women complained more about the typical symptoms of depressive disorder according, while men complained more about anger, irritability, waking up early in the morning and alcohol abuse.

COMBINED TREATMENT OF PATHOSOSPERMIA WITH ADJUVANT THERAPY WITH SPEROTON COM- PLEX IN PATIENTS WITH VARICOCELE

OBJECTIVE
 To evaluate the effectiveness of combined treatment of pathozoospermia in patients with varicocele by performing micro- surgical phlebectomy of varicose veins of the spermatic cord in combination with adjuvant therapy with the Speroton complex
 MATERIAL AND METHODS
 Twenty microsurgical phlebectomies of varicose veins of the spermatic cord were performed in patients with pathozoo- spermia (oligoasthenospermia) against the background of varicocele with the appointment of the Speroton complex in the postoperative period for 3 months with an assessment of spermogram parameters before and after the operation in comparison with a group of 20 men with pathozocelemia without the use of adjuvant therapy. The study of morphological and functional parameters of spermogram of men of reproductive age (18-49 years) without signs of immune infertility (MAR-test IgG <10%) before and after the start of treatment was carried out. The average age of men was 33 ± 2.3 years (M ± m).
 RESULTS
 All patients with infertility in combination with varicocele had oligoasthenozoospermia before treatment. Three months after the start of treatment in the study groups, there was a statistically significant improvement in sperm counts due to an increase in the concentration of spermatozoa in 1 ml of ejaculate, an increase in the number of progressively mobile forms and total motility of spermatozoa by 50-68%, an increase in the number of live sperm by 19-20% and a decrease in the num- ber of dead forms of spermatozoa by 30-35%. A statistically significant decrease in the DNA fragmentation index by 34-52% (p <0.05) was found in all study groups. It was found that combination therapy, including microsurgical phlebectomy of the spermatic cord veins using the Speroton complex for 3 months, statistically significantly led to an increase in the concentration of spermatozoa in 1 ml of ejaculate (38.6 [38.2; 69.4]), an increase in progressively mobile forms (49.2 [26.7; 47.2]%) and general motility (72.2 [35.3; 64.7]%) of spermatozoa and viable forms (67.8 [39.3; 81.7] %), a decrease in the DNA fragmenta- tion index compared with the spermogram indicators of patients who underwent only microsurgical phlebectomy (p <0.05 for all study indicators). In the group of patients after combined treatment with the inclusion of adjuvant therapy of the Speroton complex, there was a statistically significant decrease in the sperm DNA fragmentation index to almost normal values (12.1 ± 1.1%) compared with the group of patients who underwent only surgery (17.2 ± 0.8%) (p = 0.01). Combined treatment (micro- surgical phlebectomy of the veins of the spermatic cord in combination with adjuvant therapy Speroton) of pathozoospermia in men of reproductive age with infertility on the background of varicocele can significantly improve the morphofunctional parameters of spermogram after 3 months from the start of treatment compared to men who underwent only surgical correction of varicocele.

Gaitada Gizli Kan Pozitifliği Nedeniyle Kolonoskopi Yapılanlarda Kolorektal Malignite Sıklığı

Giriş ve Amaç: Kolorektal kanserlerin erken evrede belirlenmesi, prognozun iyileştirilmesindeki en önemli kısımdır. Bunun yolu etkili tarama programlarından geçmektedir. Gaitada gizli kan (GGK) testi tarama yöntemlerinin başında gelmektedir. Bu çalışmada endoskopi ünitemizde GGK testi pozitifliği nedeniyle kolonoskopi yapılan hastalarda kolonoskopik bulguları değerlendirmeyi, polip sıklığını, histopatolojik tiplerini ve kolorektal malignite sıklığını saptamayı amaçladık.
 Materyal ve Metod: 2018 Aralık ve 2019 Temmuz ayları arasında GGK pozitif olup etyoloji araştırılması nedeniyle kolonoskopi yapılan hastalar çalışmaya alındı. Kolonoskopi uygun hazırlık sonrası terminal ileum da değerlendirilecek şekilde uygulanmıştı. Hastaların yaş, cinsiyet, anamnez bilgileri, kolonoskopi ve patoloji sonuçlarına dosya bilgileri araştırılarak geriye dönük olarak ulaşıldı.
 Bulgular: Bu sürede GGK pozitifliği nedeniyle 70 hastaya kolonoskopi yapılmıştı. Hastaların 36 (%51)’sı erkek, 34 (% 49)’ü kadındı. Erkeklerin yaş ortalaması 50,1±14,8, kadınların yaş ortalaması 54,6 ± 13,9 idi. Olguların 13 (%19)’ünde adenomatöz polip, 4 (%5,7)’ünde adenokarsinom ve birinde (%1,4) malign melanom tespit edildi. Polip tespit edilen 7 erkek ve 6 kadın hastanın yaş ortalamaları 61,5±9 idi. Poliplerin %76’sı sol kolonda, malignitelerin %80’i rektosigmoid kolonda idi. Olguların %74’ünde GGK pozitifliğini açıklayacak bir patoloji saptanmamıştı. Poliplerin tamamı kolonoskopik yöntemlerle başarıyla çıkarılmıştı. 
 Tartışma ve Sonuç: GGK pozitifliği nedeniyle kolonoskopi yapılan olguların %7’sinde kolorektal malignite ve %19’unda adenomatöz polip saptanması GGK testi pozitifliğinin önemini göstermektedir. Tarama programları sayesinde kolorektal kanserler ve prekanseröz lezyonların erken teşhis edilip, sağ kalım oranlarının artabileceği görülmektedir.

PCN112 Estimating Resources Utilization and Health Care Costs Related to Colorectal Cancer Patients in Saudi Arabia

This study aimed to estimate the resources utilization and costs of colorectal cancer in Saudi Arabia. A retrospective single-centered cohort study of all CRC patient from January 2016 to December 2019, all patient’s information was extracted from the Electronic Health Record of King Khalid University Hospital (KKUH). The study included all medical management cost of CRC in patients (≥18 years) with confirmed diagnosis of colorectal cancer, and excluded patient who did not receive any kind of medical management for CRC, or files with missing information. The total cost was calculated according to KKUH own price. A total of 326 colorectal patients were eligible for this study. Around two thirds of the cases were male and most of the patient 89% were Saudi. The average age for men was 59.2 and for women was 55.27. The total direct medical costs for all colorectal cancer patients was $31.5 million. Around half of cases were in stage 3. The annual cost per patients were $ 96,800. Overall, our analysis found that the costs related to medication were the major driver healthcare spending among all study population (45%) followed by surgery costs (27%). The costs related to hospitalization accounted for (14%) and laboratory cost represent (7%) of total cost. Costs related to radiotherapy had the lowest impact on total spending (2%). Cost were considerably increase as stage increase were the cost per patient for stage 1 was $50,728 and it is increase to over $93,333 in stage 4. This study presented various cost details for colorectal cancer which represent a substantial cost to Saudi healthcare budget and this cost is expected to increase significantly in the future because of expected growth of aging of the population and availability of newly innovated and costly treatment.

Latent visceral obesity in men of average age with type 2 diabetes mellitus

Background and Aims: Visceral obesity is important in the development of type 2 diabetes and atherosclerosis. Its accurate assessment with usage of waist circumference and body mass index remains a subject of discussion while the alternative technologies demonstrate significant shortcomings of traditional markers.

Anatomical evaluation of the nasopalatine canal using CBCT (Cone Beam Computed Tomography): Method validation in open source software

Objective: Development and validation (using open source software) of a method for volumetric and linear assessment of the nasopalatine channel (NPC) using cone beam computed tomography (CBCT). Materials and methods: This was an observational, cross-sectional study of 276 CBCTs. Acquisition was performed on a Prexion 3D computerized tomography scanner (manufacturer), using voxels of 0.08 mm and 0.14 mm, (with FOV at 5 and 12 cm). The images were compiled and divided in accordance with gender and the dental condition of the maxilla. Evaluation took place on a MacBook Pro computer using the Horos Project program (Version 3.3.5). Linear measurements and NPC volumetric evaluations were performed after correcting the orientation axes (sagittal and axial). The length and ROI volume tools were used. Results: The average age for men was 60.15 ± 11.94, for women it was 59.95 ± 10.63. Respectively, for men and women, the average NPC volume values ​​ were: 68.59 mm3 and 59.37 mm3 (p = 0.032), for length they were 10.08 mm and 8.84 mm (p = 0.000). Of the dentate participants, the NPC averages for volume for men and women were: 71.01 mm3 and 57.18 mm3 (p = 0.007), for length they were 10.26 mm and 9.14 mm (p = 0.001). In the edentulous, the average NPC lengths were 9.79 mm (men) and 8.37 mm (women) (p = 0.005). Conclusion: For linear and volumetric nasopalatine channel assessment, the post-processing method used in the Horos software was considered precise and easy-to-use.

Suicides in Belgrade, Serbia in the period 2009-2018

Abstract Background Suicides fall in violent deaths and more recently have shown an increasing trend in developed and developing countries. This is a major public health problem that could and should be prevented. Unfortunately, it is among the top twenty leading causes of death worldwide. This public health problem exists in Belgrade and Serbia, as well. Methods An analysis of death certificates shows an insight into the causes of death of inhabitants of Belgrade. The paper presents data from the Database of deceased persons in Belgrade, for the period 2009- 2018. Data are analyzed using frequencies and incidence rates by sex, age groups, month of death, day of death, and municipality of residence of deceased. Results In Belgrade, from 2009 to 2018 the incidence rate of suicides is decreasing. The standardized suicide rate was highest in 2009 (12/100.000). Men often committed suicides at all observed years, and the rates are usually higher as in women. The highest number of suicides occur in April, July and June and observing days within a week Wednesday and Tuesday lead. The average age of men who committed suicide was 57 years and women 59.5 years. The most common method of carrying out the suicide was 'by hanging, strangulation and suffocation' (X70 according to ICD-10) and frequency was 45.2%. Conclusions The incidence rate of suicides at Belgrade territory shows the trend of decline in the observed period, between 2009 and 2018. Besides that, other attributes indicate that age-sex-manner of suicides could be changed, as for being targeted for prevention. Preventing suicides is a new challenge for public health and all public sectors have to be involved in prevention. Considering ageing of a population, migration and other negative demographic trends in Belgrade and Serbia, it is necessary to raise our competencies in inhibition of these unfortunate events. Key messages Preventing suicides is a challenge for public health. It is necessary to raise competencies in order to prevent suicides.

Ureteral laparoscopic surgery in cancer patients

Objective: to improve the results of treatment of cancer patients with strictures and obliteration of the ureters after surgery and/or remote radiation therapy. Materials and methods . The study included 6 men and 12 women. The average age of men was 67 + 8.5 years (53—79years) and 46 + 15.8 years (28—74years) among women. According to the results of X-ray examinations, the average length of cicatricial narrowing of the ureter was determined, after which the tactics of surgical treatment were determined. Results. The duration of surgical treatment rangedfrom 97 to 380 minutes. Intraoperative blood loss in all groups was approximately the same and ranged from 20 to 160 ml. Intraoperative complications occurred in one patient (5.5 %), injury of the intestine. The described damage was repaired by the intracorporeal manual suture. All operations were completed laparoscopically. A generalized indicator of postoperative complications reached 16.7 %. All the complications that occurred had a slight effect on the the rehabilitation period. Conclusion. The results of this work indicate that ureteroplasty in patients after cancer treatment can be performed by laparoscopic access, which significantly reduces the invasiveness of surgery, reduces the length of hospital stay and rehabilitation of patients. Also, the possibilities of laparoscopic surgery allow you to achieve better visualization, to form more precise sutures.

DIFFERENCES OF THE HEALTH- RELATED QUALITY OF LIFE OF THE SENIOR CITIZENS

The aim of the study was to examine the health-related quality of life (HRQoL) of the elderly in Poland. Researcher investigated if differences between gender groups were influenced by other variables such as period of ageing („young-old” vr „old-old”) and place of residence (big city, small town, village). The study sample comprised 2565 elderly who were at least 60 years of age. The average age for men was 72,76 and for women 72,39. The health-related quality of life was evaluated using the Polish adaptation WHOQOL-BREF questionnaire. Respondents rated both quality of life and general health well. Nevertheless the health-related quality of life domains’ rating decreases with age. Women are commonly less satisfied with the WHOQOL-BREF domains. Men living in little towns declared not only a high level of quality of life, but their estimates in the early and late old age are similar. The diversity of health-related quality of life needs further investigation along with a number of more subjective indicators of individual experiencing one’s old age (e.g. sense of one’s time of life or the awareness of age-related changes).