Biomedical subjects
Publications and source records attributed to H Vlajinac.
Conditional logistic regression analysis of case-control study data showed that the following factors were significantly related to rheumatic fever occurrence: home dampness, change of place of residence during the last 5 years, low education of mother, body weight below normal, frequent sore throat and positive family history of rheumatic fever.
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In this article we discuss the epidemiologic changes in rheumatic fever leading up to the recent resurgence. The multifocal outbreaks occurred within the same time period, 1984 to 1988, in different sections of the United States and in Italy and Chile. The clinical manifestations in the current outbreaks were strikingly different than in the recent past--carditis was frequently present and very severe. One of the most unsual demographic features was that the majority of the patients lived in suburban or rural communities and were mostly white and middle class. However the average size of the families in which the index cases occurred was higher than in the corresponding populations, pointing out to the importance of crowding for spreading of streptococcal infectious and rheumatic fever occurrence. Still another contrast to prior outbreaks was that the recent ones did not follow clinically apparent epidemics of streptococcal infections. It is clear from the resurgence of acute rheumatic fever in the mid--1980s in developed countries among people with good living conditions, that rheumatic fever is worldwide problem. Intesified efforts to understand the pathogenesis of rheumatic fever should undertaken, but in the meantime, the preventive methods that are available should be vigorously applied.
From 1969 to 1983, 3658 death cases of stomach cancer in Yugoslavia were recorded, the standardized mortality rate being 15.9 per 100,000. In the same period, the highest mortality rates were noticed in Slovenia--23.5% and in Croatia and Macedonia--21.5% in each republic. Serbia and Bosnia and Herzegovina followed with 21.5 deaths from stomach cancer per 100,000 in each republic. Montenegro has the lowest mortality rate--5.7%. During 15 years, there was a marked decrease of the stomach cancer mortality for both sexes in Yugoslavia; the equation of the linear trend were y = 24.9-0.23x for males and y = 12.3-0.6x for females. According to the WHO statistical data on the stomach cancer mortality, Yugoslavia occupies the middle place among the countries with high and low risks of cancer.
The smoking behaviour of 54.0% of all medical students in Belgrade University is analysed. About one-third are current smokers. Most male students smoke 11-20 cigarettes per day and most female students smoke 1-10 cigarettes daily. The relationship between parents' and students' smoking habit is distinct, especially in female students and when both parents are smokers. The significant association with parental smoking is present only in students who became smokers before the age of 19 and in students who smoke 11 or more cigarettes per day.
A hospital-based case-control study of myocardial infarction in young women conducted in Belgrade from January 1983 to December 1986 is presented. A total of 58 women with infarction, aged 30 to 50 years were compared with 174 age-matched controls. Smoking of 15 or more cigarettes per day, diabetes, hypertension, angina pectoris and hypercholesterolaemia, all significantly elevated the risk of myocardial infarction. Relative risk among past users of oral contraceptives (crude RR = 2.48, 95% Cl = 0.98-6.23) remained elevated after stratification for the other five significant risk factors. Although remaining small, this study is consistent with already published work on the subject. Lack of agreement with the previous study in Belgrade is explained.
Subject to examination were 80 patients with gastric carcinoma and 80 control patients admitted to the same medical institutions but with no malignant diseases. The groups were compared by sex, age and residence. Different levels of exposure to hypothetic factors were assessed by means of standard tests employed in the examination of matched pairs. It has been established that such habits as tobacco-smoking, consumption of alcoholic drinks and coffee in large amounts as well as the presence of malignant diseases in the familial anamnesis increase the risk of affliction with gastric carcinoma.
One hundred and fourty-eight rheumatic fever patients and 444 controls matched by age, sex and place of residence, were interviewed about socio-economic and some other variables. Socio-economic factors recognized as risk factors for rheumatic fever (flat dampness, more than 2 persons per room, sleeping in bed with other person, low education of mother and undernourishment) were of lesser importance for persons with frequent sore throat in comparison to persons without frequent sore throat. According to the results obtained it seems that there is positive connection between host's propensity to clinical manifestation of throat infection and manifestation of rheumatic fever. The lesser susceptibility the more additional factors are needed for Rheumatic Fever to occur. The relative importance of socio-economic factors in rheumatic fever occurrence depends on host's susceptibility to infection.
This investigation of some biosocial factors such as level of education, profession, tobacco smoking, alcohol and coffee consumption, and previous illnesses, reports on 98 patients with histologically confirmed rectal cancer, and 196 hospitalized and neighborhood-matched controls. Past history of hemorrhoids, polyposis, colitis, diverticulosis and appendectomy, as well as the use of laxatives were significantly more frequent among rectal cancer patients than in their controls. None of the case-control differences related to the other parameters reached statistical significance.
Reproductive history, contraceptive use, family history of breast cancer, health behaviour and socioeconomic variables of 60 women with breast cancer were compared to those of 71 age and place of living matched hospital controls. Besides nulliparity, all known risk factors for breast cancer were more frequently present in the cases observed, although the statistical significance was not attained (age at first delivery, early menarche, positive family history of breast cancer, positive history of benign breast disease, obesity). Oral contraceptives ever used were reported for 16.7% of cases and 15.5% of controls (RR = 1.09; 95% confidence interval 0.42-2.77). Although the study is small and the difference in the risk factor distribution insignificant, it is clearly consistent with many published studies on the same subject.
In a case control study we evaluated the effects of socioeconomic and some other factors on the risk of Rheumatic Fever (RF) occurrence. We compared 148 patients, with RF first attack, with 444 controls individually matched to the patients for age, sex, and place of residence. The unemployment of parents was found to be the most closely related to RF, the estimated relative risk (RR) being 10.37 (95 per cent confidence limits 5.31 to 20.24). Among other socioeconomic factors, the following were found to be significantly related to RF: low education of mother, the RR being 2.58 (CL 1.38 to 4.83), change of place of residence during last 5 years, the RR being 5.00 (CL 1.52 to 7.93) and poor living conditions, that is, deteriorated condition of dwellings, the RR being 1.83 (CL 1.12 to 2.98), home dampness, with the RR of 2.48 (CL 1.34 to 4.61) and home crowding expressed as more then 2 persons per room, the RR being 1.72 (CL 1.08 to 2.72), less then 5 m2 of living space per capita, with the RR of 2.83 (CL 1.19 to 6.71) and sleeping in bed with other person, giving the RR of 1.65 (CL 1.02 to 2.66). Out of other factors observed, that were the subject matter of the study, history of frequent sore throat and family history positive on RF were found to be significantly more frequent in patients then in their controls, with corresponding RR of 2.01 (CL 1.41 to 2.89) and 2.81 (CL 1.68 to 4.69) respectively.
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This paper presents the results of a comparative biosocial study between 186 patients with large bowel cancer and two groups of matched controls, each with 186 persons. One of these groups was from hospitalized patients, the other from the neighbourhood of the cancer patients. Bowel cancer patients and their controls were compared with regard to level of education, profession, physical activity in job, smoking habits, alcohol and coffee consumption and previous illnesses. The only parameters that were statistically different between cancer patients and both controls were haemorrhoids and use of laxatives, that were found to be increased in the cancer group. Higher education level, coffee consumption, polyposis, appendectomia were significantly more presented in bowel cancer patients but only in comparison to one control group. Out of the other diseases of the digestive tract, cases and controls differed with respect to cholecystitis, cholecystectomy and to diabetes.
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One thousand and fifty-nine Shigella sonnei strains were submitted to biotyping and colicine typing. Simultaneous use of biotyping and colicine typing may be considered of value in epidemiological tracing.
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Eighty-one colon cancer patients and 162 matched controls from hospital and neighbourhood were interviewed about past dietary habits. Statistically significant differences between cases and controls were found in the total consumption of meat (excluding fish), as well as in the consumption of lamb. There was no case-control difference either in consumption of fibrous foods or in consumption of foods with at least 5% saturated fat.