A case-control study was conducted in order to assess possible relationships between life events and Graves' disease. The study included 100 newly diagnosed patients with Graves' disease and 100 controls matched with respect to sex, age ( +/- 2 years) and type of residence (rural, urban). Paykel's Interview for Recent Life Events (a semistructured research interview covering 61 life events) was administered to each subject. In comparison with controls, the patients claimed to have had significantly more life events in the 12 months preceding the diagnosis (p = 0.0001). The following eight life events were significantly more prevalent among patients than controls: change in time spent on work (much overtime work, second job, much less work than usual) (McNemar = 12.04; RR = 7.00; 95%CI = 2.35-20.80; p = 0.0001), unemployment for at least 1 month (McNemar = 4.00; RR = 8.00; 95%CI = 1.04-61.39; p = 0.039), arguments with one's superior at work or a co-worker (McNemar = 4.50; RR = 3.50; 95%CI = 1.10-11.08; p = 0.031). change in the work conditions (new company division, new chief, large reorganization) (McNemar = 4.26; RR = 4.00; 95%CI = 1.07-14.92; p = 0.035), increased arguments with spouse (McNemar = 6.75; RR = 11.00; 95%CI = 1.82-66.44; p = 0.006), increased arguments with fiancé/fiancée or a steady date (McNemar = 4.00; RR = 8.00; 95%CI = 1.04-61.39; p = 0.039), hospitalization of a family member for serious illness (McNemar = 3.76; RR = 3.25; 95%CI = 1.01-10.68; p = 0.049) and moderate financial difficulties (McNemar = 8.50; RR = 3.25; 95%CI = 1.47-7.16; p = 0.003). Our findings indicate that life events may be a risk factor for Graves' disease.
The retrospective cohort study comprised 97 Balkan endemic nephropathy (BEN) and BEN-suspected patients discovered in 1971 in the field examination in the village of Šopić, one of the regions most frequently affected by the disease. Our aim was to determine the outcome of the disease in patients and to compare the survival of BEN-suspected and BEN-manifested patients and the survival of their kidneys. The mean survival time was 16.4 years for all patients (95% CI 14.51–18.21) and 23.1 years for suspected and 13.3 years for manifested patients (log-rank = 19.46; d.f. = 1; p < 0.001). According to our results, it can be concluded that BEN is characterized by slow course and prolonged evolution and that the prognosis was consistently better for BEN-suspected than for BEN-manifested patients.
A total of 366 inhabitants of a village affected by Balkan nephropathy (BN) have been followed over 12 years. It was shown that depth of the well to the water level, height of the water column, electroconductivity, and NO3 content of he water were not associated with BN. The risk of developing the disease was significantly higher if a well was at a lower altitude and contained a higher concentration of SiO2. Low altitude might have been expected to correlate with the BN frequency; as for silica, however, there are sound indications that it could just be a correlate of a cause rather than a direct determinant of BN.
The highest relative risk of developing tumours of the renal pelvis and ureters (TPU) in a general population is confined to areas where Balkan nephropathy (BN) is endemic. Whether there is a higher frequency of cancer of any site in families with TPU cases from this BN endemic part of the world was tested by a case-referent study. A group of 65 rural patients with histologically proven TPU was individually matched with the same number of their nearest neighbours, who served as controls. Comparison of age-standardized ratios revealed that over a period of 30 years family members of the cases experienced a significantly higher risk of (non-urinary) cancer deaths than family members of their pairmates.
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