Lymphoma patients are at increased risk of thromboembolic events but thromboprophylaxis in these patients is largely underused. We sought to develop and validate a simple model, based on individual clinical and laboratory patient characteristics that would designate lymphoma patients at risk for thromboembolic event. The study population included 1,820 lymphoma patients who were treated in the Lymphoma Departments at the Clinics of Hematology, Clinical Center of Serbia and Clinical Center Kragujevac. The model was developed using data from a derivation cohort (n = 1,236), and further assessed in the validation cohort (n = 584). Sixty-five patients (5.3%) in the derivation cohort and 34 (5.8%) patients in the validation cohort developed thromboembolic events. The variables independently associated with risk for thromboembolism were: previous venous and/or arterial events, mediastinal involvement, BMI>30 kg/m(2) , reduced mobility, extranodal localization, development of neutropenia and hemoglobin level < 100g/L. Based on the risk model score, the population was divided into the following risk categories: low (score 0-1), intermediate (score 2-3), and high (score >3). For patients classified at risk (intermediate and high-risk scores), the model produced negative predictive value of 98.5%, positive predictive value of 25.1%, sensitivity of 75.4%, and specificity of 87.5%. A high-risk score had positive predictive value of 65.2%. The diagnostic performance measures retained similar values in the validation cohort. Developed prognostic Thrombosis Lymphoma - ThroLy score is more specific for lymphoma patients than any other available score targeting thrombosis in cancer patients. Am. J. Hematol. 91:1014-1019, 2016. © 2016 Wiley Periodicals, Inc.
Background/Aim. Along with the great impact of 2019 coronavirus disease (COVID-19) on physical health, social functioning, and economy, this public health emergency have significant impact on mental health of people as well. Assessment of the impact of outbreak-related information and public trust in the health system and preventive measures during the COVID-19 outbreak in Serbia in 2020 on levels of anxiety and depression in education, army and healthcare professionals. Methods. An anonymous questionnaire was disseminated to skilled professionals working in fields of education, army, and healthcare. The questionnaire included Beck Anxiety Inventory, Zung Self-Rating Depression Scale, as well as the section assessing the perceived disturbance by the outbreak-related information and the trust of participants in healthcare system and preventive measures proposed by the crisis team. Results. Out of 110 subjects enrolled in this study (mean age 35.25?9.23 years), 59.1% were women. Among healthcare workers, the frequency of perceiving outbreak-related information available on public media as disturbing, as well as the average level of anxiety, were higher compared to the group of army professionals (p<0.05). Women also perceived outbreak-related information available on public media as disturbing in a higher percentage compared to men (p<0.01), and had higher levels of anxiety (p=0.01) and depression (p<0.05). The lack of public trust was associated with higher levels of depression, and the perception of outbreak-related information as disturbing with higher levels of both anxiety and depression. Conclusion. Significant perception of outbreak-related information as disturbing among healthcare workers, as well as the lack of trust in healthcare system and preventive measures proposed by the crisis team are important factors influencing the mental state. This finding has the guiding purpose for competent institutions to make efforts to increase public trust, as one of the important preventive measures, in order to preserve and improve the mental well-being of the population in epidemiological situations.
The Aim: analysis of the influence of dispatcher assistance during cardiopulmonary resuscitation (CPR) of patients with out-of-hospital cardiac arrest (OHCA) in achieving return of spontaneous circulation (ROSC), better survival at the scene, survival to discharge, and 30-day survival.Materials and methods. This study includes epidemiological data on OHCA collected by the study protocol of the European Resuscitation Council's EuReCa_ONE study during the period October 1, 2014 — December 31, 2019. Statistical analysis was performed using SPSS Statistics v26 and GraphPad Prism v8 software packages.Results. This study included 288 patients with OHCA where CPR was provided by bystander. Dispatcher-assisted CPR (DA-CPR) occurred in 56.9% of those patients and ROSC was achieved in 31.3% of cases. Forty-four patients were hospitalized and 16 of those survived until discharge. There was no influence of dispatcher assistance on ROSC, although it resulted in slightly greater risk of the absence of ROSC (OR=1.063). Higher mortality rate to discharge occurred in DA-CPR group (P=0.013). No statistical significance was observed between DA-CPR and non-DA-CPR groups in terms of death at the scene, and 30-day survival. Dispatcher assistance during the initial CPR in hospitalized OHCA patients was a significant predictor of death outcome during hospitalization (P=0.017, OR=5.500).Conclusions. There is no significant association between the presence/absence of dispatcher assistance and ROSC or 30-day survival rate. In contrast, DA-CPR was non-significantly associated with slightly higher odds for the absence of ROSC. DA-CPR was also associated with lower survival-to-discharge rates in hospitalized OHCA patients. The study findings are the base/ground which highlights the need of implementation of existing and development of new guidelines regarding high-quality professional training of EMS dispatchers as well as basic life support education of general population.
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