RESUMEN
BACKGROUND: The risk factors implicated in the genesis of chronic subdural hematomas include old age, alcoholism, diabetes mellitus, arachnoid cysts, coagulopathy, anticoagulant (ACTh) and antiplatelet drugs. However, no study has reported an association between arterial hypertension (HTA) and chronic subdural hematomas. Therefore, the aim of this study was to investigate whether HTA is a risk factor for spontaneous chronic subdural hematomas (SCSDHs). METHODS: This multicenter study included patients aged over 60 years and was conducted from January 2009 to the end of 2015. One hundred and twenty-two patients with SCSDHs and 111 controls treated for other reasons with no evidence of intracranial hemorrhages on brain computed tomography were enrolled. The patients were separated into three age subgroups to provide a better insight into the role of risk factors with age. RESULTS: The average age in the SCSDH group was 74.45 ± 8.16 years, compared to 71.28 ± 6.69 years in the control group. The SCSDH group was significantly older than the control group (p = 0.0014). The patients in the 60-69 years age group diagnosed with SCSDHs had significantly higher rates of HTA (p = 0.0519), ACTh treatment (p = 0.0292) and alcoholism (p = 0.0300) than the control group. The patients in the 70-79 years age group diagnosed with SCSDHs had significantly higher rates of HTA (p = 0.0071) and ACTh treatment (p = 0.0158) than the control group. In the subgroup of patients older than 80 years, there were no statistical differences. CONCLUSION: The incidence of HTA had borderline significance in the patients aged 60-69 years with SCSDHs and statistical significance in the patients aged 70-79 years with SCSDHs. Anticoagulant therapy was the most significant risk factor. Among the patients with SCSDHs aged 60-69 years, the percentage of heavy drinkers was significantly higher than in the control group.
Asunto(s)
Hematoma Subdural Crónico/etiología , Hipertensión/complicaciones , Factores de Edad , Anciano , Anciano de 80 o más Años , Alcoholismo/complicaciones , Anticoagulantes/efectos adversos , Complicaciones de la Diabetes/etiología , Femenino , Humanos , Masculino , Inhibidores de Agregación Plaquetaria/efectos adversos , Factores de RiesgoRESUMEN
PURPOSE: The purpose of this study was to present the Screening Registry and the results of organized cervical cancer screening program (OCCSP) in the Republic of Serbia using a database made as an output model, linked with the Screening Registry. METHODS: Data were respectively collected over a onemonth period from 3 state primary health care centers (and related hospitals/clinical center) in central Serbia in which OCCSP was conducted. The sample consisted of women of the target population (25 to 64 years old) who responded the call for Pap test. RESULTS: The most frequent abnormal cytological diagnosis was in the 38-50 years age group, and consisted of atypical squamous cells of undetermined significance - ASCUS (7.5%) and low grade squamous intraepithelial lesions - L-SIL (7.3%). The most frequent abnormal colposcopic finding in the youngest age group of women (25-37 years) was iodine negative epithelium (35.7%) and in the group of women aged 38-50 and 51-64 years acid-white epithelium. The most common histopathological diagnosis was L-SIL. Positive predictive value of colposcopy in relation to the Pap test was 0.64 (95% CI=0.56-0.70). Interrater agreement (between cytotechnicians and supervisors) measured by the Cohen's coefficient was 0.94 (95% CI=0.91 to 0.97), but between cytology (supervisors) and pathology findings it was 0.83 (95% CI = 0.67 to 0.99). CONCLUSION: The existence of a screening registry contributes to a better epidemiological surveillance of a screening program, and to a possibility for development of various epidemiological researches.