Association of Tumor Necrosis Factor-Alpha with Psychopathology in Patients with Schizophrenia.

We investigated the relationship between serum tumor necrosis factor-alpha (TNF-α) levels and psychopathological symptoms, clinical and socio-demographic characteristics and antipsychotic therapy in individuals with schizophrenia. TNF-α levels were measured in 90 patients with schizophrenia and 90 healthy controls matched by age, gender, smoking status, and body mass index. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychopathology in patients. No significant differences in TNF-α levels were detected between the patients and controls (p=0.736). TNF-α levels were not correlated with total, positive, negative, general, or composite PANSS scores (all p>0.05). A significant negative correlation was observed between TNF-α levels and the PANSS cognitive factor (ρ=-0.222, p=0.035). A hierarchical regression analysis identified the cognitive factor as a significant predictor of the TNF-α level (beta=-0.258, t=-2.257, p=0.027). There were no significant differences in TNF-α levels among patients treated with different types of antipsychotics (p=0.596). TNF-α levels correlated positively with the age of onset (ρ=0.233, p=0.027) and negatively with illness duration (ρ=-0.247, p=0.019) and antipsychotic treatment duration (ρ=-0.256, p=0.015). These results indicate that TNF-α may be involved in cognitive impairment in schizophrenia, and would be a potential clinical-state marker in schizophrenia.

Personality Traits and Health Related Quality of Life in Patients with Irritable Bowel Sindrome and Inflammatory Bowel Disease.

BACKGROUND: Personality traits as alexithymia and type D personality may impair health related quality of life (HRQoL) in patients with irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD). Aim of this study was to evaluate personality traits in patients with IBS and IBD and their impact on HRQoL. MATERIALS AND METHODS: The subjects (40 patients with IBS, 40 with IBD and 40 health control subjects) completed SF-36 questionnaire, TAS-20 and DS14 scale. RESULTS: Patients with IBS and IBD had higher results on TAS-20 and DS14 scale when compared with healthy controls. Also IBS patients had higher scores than IBD patients. Higher scores on TAS-20 and DS14 scales in IBS and IBD patients correlate with lower HRQoL. HRQoL was poorer in IBS and IBD patients than in healthy control subjects. CONCLUSIONS: Alexithymia and type D personality in IBS and IBD patients are associated with lower HRQoL and psychological interventions should be considered.

Association between Resilience and Quality of Life in Patients with Colon Cancer.

INTRODUCTION: Colon cancer is one of the most common malignancies. Numerous studies suggest an association between resilience and quality of life in colon cancer patients. The aim of this study was to explore the association between resilience and quality of life in people with colon cancer. SUBJECTS AND METHODS: A cross-sectional study was conducted on a sample of 200 subjects at the Oncology Clinic of the University Clinical Hospital Mostar. Data were collected in the period between April 2019 and June 2021. A socio-demographic questionnaire specifically designed for this study, a CD-RISC-25 scale for assessing resilience, and a WHOQOL-BREF questionnaire for assessing quality of life were used for collecting data. RESULTS: A statistically significant positive association of resilience with all domains of quality of life was found. The mental health domain contributed the most statistically significantly positively to the level of resilience. Patients who were not married had a statistically significantly higher level of resilience compared to married, divorced and widowed patients. No statistically significant difference was found in resilience levels relative to other socio-demographic factors and cancer stage. Patients treated with a combination of surgery and chemotherapy had a statistically significantly higher level of resilience compared to patients treated with other therapeutic methods. CONCLUSIONS: Higher level of resilience statistically significantly contributes to a higher level of quality of life in people with colon cancer.

Mental Health and Self-Esteem of Active Athletes.

INTRODUCTION: Systematic and continuous physical exercise of certain intensity and volume is irreplaceable in the stages of growth and development and in preventing impairments of the biological, functional and health state of the human organism.Many studies show that physical exercise contributes to development and reinforcement of mental health and increases self-esteem. Examine mental health and self-esteem of active athletes. SUBJECTS AND METHODS: The subjects of the study are active athletes from Herzegovina and students of the Faculty of Health Studies in Mostar. Mental health and self-esteem were measured by a sociodemographic questionnaire, The Symptom Checklist-90 and the Satisfaction With Life Scale. RESULTS: There is a statistically significant difference in the frequency of exercise, active athletes have the highest percentage (100%) and state that they exercise often (almost every day) while university students have a significantly lower percentage (20%).Students scored significantly higher on the subscales for somatization, obsessive - compulsive symptoms, interpersonal vulnerability, depression, anxiety, aggression, phobia, and paranoia than active athletes. Active athletes have statistically higher scores for almost all the claims of the subjective assessment of life satisfaction. CONCLUSION: Active athletes showed significantly less psychological symptoms and better mental health, greater life satisfaction and higher self-esteem than students of the Faculty of Health Studies in Mostar.

Correlation of Religiousness with the Quality of Life and Psychological Symptoms in Oncology Patients.

INTRODUCTION: Malignant diseases are one of the leading mortalities in the world, causing a range of psychological symptoms and reducing the quality of life in oncology patients. Examine the correlation of religion with the quality of life and psychological symptoms in oncology patients. SUBJECTS AND METHODS: The cross-sectional study included 100 oncology patients in the test group and 80 internal medicine patients in the control group. A sociodemographic questionnaire was specifically designed for this study, the Duke University Religion Index, the Symptom Check List 90, and the WHOQOL-100 quality of life assessment were used to collect the data. RESULTS: The average score in oncology patients was significantly lower on the subscales for physical health (p<0.000), social connections (p<0.002), and intrinsic religiousness (p<0.046) in comparison to internal medicine patients. On the psychological symptoms scale, the average score was higher in oncology patients with the largest difference observed on the psychoticism subscale (p<0.078). CONCLUSION: Oncology patients are statistically less religious and are not satisfied with the quality of life in comparison to internal medicine patients. Psychological symptoms are more pronounced in oncology patients but the difference is not statistically significant. A lower level of religiousness is statistically negatively correlated with a higher severity of psychological symptoms.

Psychic Symptoms and Self-Esteem in Dancers.

INTRODUCTION: The mental health of the human being and a higher level of the self-esteem have the positive effects on the peace surrounding, stability, success and the personal satisfaction of any individual. The fundamental opinion is that the dance has the affect on the body and the psychical health of the people. To explore if the dancers have their less-expressed psychical symptoms and higher self-esteem. SUBJECTS AND METHODS: The examination was performed on the sample of 310 examinees, mostly of the young life age and who identified themselves as the dancers or non-dancers. For the requirements of the investigation there were used the socio-demographic question-form, the psychical symptoms estimation scale (RCL-90-R) and the Rosenberg self-esteem scale (RSES). RESULTS: The dancers show the smaller appearance of the psychical symptoms and that almost in all sub-scales, but their difference is not statistically significant. The statistically significant difference among the men and the women was recorded in the subscales of the somatisations, then the interpersonal vulnerability, the depression, the anxiety and the phobias. The dancers possess their higher self-esteem then the non-dancers, but statistically their difference is not significant. Comparing the results against the sex, the persons of the female sex possess the higher self-respect than the persons of the male sex. CONCLUSION: The dancers possess less of the psychical symptoms and their higher self-esteem than the non-dancers, but the difference within the results is not significant statistically.

Addictions without Drugs: Contemporary Addictions or Way of Life?

In the five thousand years of recorded history there is written evidence of various types of addiction. In recent decades scientists focus their attention on addictions without the immediate introduction of psychoactive substances into the organism or the so-called "addictions without drugs". Studies have revealed a number of similarities between drug addictions and addictions without drugs that also carry biological, psychological and social consequences in the form of addictive activity carvings, adrenaline alarm, dopamine and serotonin secretion, tolerance and abstinence syndrome same as classical forms of addiction. Although the physiological effect of addiction without drugs on the brain and nervous system is not yet sufficiently explored, scientists have found equivalent effects on addicts suffering from one or the other type of addiction. These addicts are almost generally dysfunctional persons who become prisoners of their own passions, and the consequences are numerous technological advantages offered by modern times and in some respects a punishment due to the civilization for forgetting the man himself. Considering that most people, so and many psychiatrist, often accept these addictions as a lifestyle and without any delay and awareness of the potential dangers they may pose, we can with certainty say that the so-called "addictions without drugs" are the scourge of the 21st century. With pathological gambling, which is as old as human civilization, in recent decades we meet the growing problems of internet addiction, gambling games, which are classified for the first time at DSM V in addictive disorder, uncontrolled shopping, food cravings, addiction to sex, weight loss, sports, work and many more, which are mostly true addictions, and not only the way of life. The aim of this paper is to point to the growing problem of addiction without drugs, which is becoming an increasing problem within our community.

ABO and RhD Blood Groups in Nasal Polyposis.

OBJECTIVE: The aim of this study was to determine ABO and RhD blood group distribution in nasal polyposis (NP) patients and whether there is a specific ABO or RhD blood phenotype associated with susceptibility to or protection with respect to development of NP. METHODS: The study group comprised 126 consecutive patients with chronic rhinosinusitis and bilateral NP. The control group comprised 126 healthy blood donors. All participants were from the same geographical region. Distribution of ABO and RhD phenotypes in all participants was studied. RESULTS: There were no significant differences between patients and controls in the distribution of the A (p=0.520), B (p=0.306), AB (p=0.673), O (p=0.894), and RhD (p=0.742) phenotypes. CONCLUSION: According to the present results, the ABO and RhD blood group systems are not associated with development of NP.

The Significance of Thallium-201-Chloride SPECT Myocardial Perfusion Imaging in the Management of Patients With Stable Chronic Coronary Artery Disease.

BACKGROUND: Patients with stable coronary artery disease (CAD) can be evaluated for myocardial viability by examining reverse redistribution of Thallium-201 (201TI) through cardiac scintigraphy. There is limited knowledge about association of a reverse redistribution with favorable cardiac outcomes. In this study, we hypothesized that higher left ventricular ejection fraction (LVEF), lower myocardial necrosis, fewer ischemic events, and less angina will be associated with reverse redistribution of 201TI imaging. METHODS: Adult patients with stable CAD included in this study underwent exercise-redistribution Thallium single-photon emission computed tomography (SPECT) and were followed for one year. LVEF and regional wall motion abnormalities were evaluated with echocardiography, exercise duration by bicycle testing, and myocardial ischemia and viability by Thallium SPECT. RESULTS: We studied 159 patients (87 men, 72 women, median age 60 years, range: 38-84) with well-developed collaterals. Those with reverse redistribution on SPECT (n = 61, 38.3%) had significantly better exercise tolerance (⩾85%; P < .001). Subjects with reverse redistribution had better LVEF (P < .001), wall motion parameters (P < .001), a lower degree of myocardial necrosis (P < .05), less angina during follow-up (P = .02), and fewer ischemic events whether treated with OMT or PCI (P < .001). CONCLUSIONS: Reverse redistribution of 201Tl on scintigraphic images is a predictor of myocardial viability. Evidence from our study suggests that optimally treated chronic CAD patients with reverse redistribution may have lower likelihood of future adverse cardiovascular events and better prognosis.

Anxiety sensitivity as a predictor of academic success of medical students at the University of Mostar.

Higher education students comprise a particularly vulnerable group for the development of anxiety symptoms and disorders. The aim of our research was to examine the impact of anxiety sensitivity on the success of medical students at the University of Mostar, and to establish the differences between students depending on their sex and the year of study. One hundred students in their first and fifth year of medical school were interviewed using the ASI questionnaire, 7 days prior to their final exams. Here we demonstrate a positive correlation between anxiety sensitivity and academic success. We did not find any significant differences between the first and fifth-year medical students, nor between participants based on their sex. We conclude that anxiety can have a positive impact on the academic achievement of higher education students.

The relationship between health locus of control, depression, and sociodemographic factors and amount of time breast cancer patients wait before seeking diagnosis and treatment.

BACKGROUND: In the Federation of Bosnia and Herzegovina, the prevalence and incidence of breast cancer has been increasing, and the national programme of early prevention, administered locally, is sporadic and without quality assurance. While many factors may influence women's decision to adopt prevention-oriented behaviours regarding breast cancer, this study has emphasised the importance of sociodemographic factors, psychological factors and mental wellbeing. SUBJECTS AND METHODS: Participants in the study were all patients who, during one year, were admitted for the first time for diagnosis and treatment in the biggest Clinical hospitals of the Herzegovina-Neretva region Patients were divided into two groups based on their TNM classification: "early stage" and "late stage". Three instruments were used in this study: an individual questionnaire about demographic and socioeconomic characteristics of the woman, the Multidimensional Health Locus of Control scales, and the Hamilton Depression Rating Scale. RESULTS: The majority of patients diagnosed with advanced disease were admitted to hospital in the late/advanced stages of the disease. Multi-variant analysis showed that the most statistically significant positive predictor for early admittance in hospital is living with family and marital status while religiosity has a negative predictive value. The results indicate that 59.7% of respondents do not have depression, while the remainder do have some degree of depression. There was no statistically significant difference in the degree of depression between women who were diagnosed and treated early and those who were not. The employment status of the respondents was the only significant factor related to degree of depression. CONCLUSION: Although health locus of control and depression are not statistically significant predictors of early hospital treatment, the recommendation is that further studies focus on the implementation of MHLC and HDRS scales within the community. This could be useful in planning appropriate and specific interventions, not only because of early diagnosis, but also to ensure good mental health and resilient behaviour.

The Impact of Religiosity on Quality of Life and Psychological Symptoms in Chronic Mental Patients.

INTRODUCTION: In recent decades, there is more and more scientific research and evidence that religiosity has a positive impact on quality of life and mental health. The aim this study is to evaluate the impact of religiosity on the quality of life and psychological symptoms of chronic mental patients. SUBJECTS AND METHODS: The test group was consisted of 100 chronic mental patients at the Clinic for Psychiatry UCH Mostar, and control group was consisted of 80 somatic patients surveyed from the Infirmary of family medicine of the Health Center Mostar. The survey was conducted by the social and demographic questionnaire, a questionnaire on the quality of life of the World Health Organization WHOQOL-BREF, the questionnaire on religiosity and self-assessment questionnaire for psychological symptoms SCL-90th. RESULTS: For the socio-demographic data we obtained results that chronic mental patients as opposed to chronic somatic patients have significantly higher percent of an average lifestyle habits. There is statistically significant difference in the place of residence, chronic mental patients live in the city as opposed to somatic who live in the countryside. On the question of religiosity we received information that the chronic mental patients in relation to chronic somatic patients significantly more attend public religious gatherings, but however, chronic somatic patients compared to chronic mental significantly more use religiosity for better financial position, social comfort. In self evaluation of psychological symptoms we received information that the chronic mental patients as opposed to chronic somatic patients had significantly more psychotic features. To test the quality of life between the two groups, we received the information that chronic mental patients have significantly better physical and mental health, social relationships and caring for the environment as opposed to chronic somatic patients. CONCLUSIONS: Quality of life was significantly better in the chronic mental patients. Also, chronic mental patients significantly more attend public religious gatherings, while chronic somatic patients significantly more use religiosity for a better financial position, social comfort. Finally, chronic mental patients had a significantly more pronounced psychotic features.

Activity of the hypothalamic-pituitary-adrenal axis and inflammatory mediators in major depressive disorder with or without metabolic syndrome.

BACKGROUND: The aim of the present study was to explore the differences in serum CRP, IL-6, TNF-α, ACTH and cortisol among patients with major depressive disorder with or without metabolic syndrome (MS) compared to a healthy control group. SUBJECTS AND METHODS: The MDD study group consisted of 80 patients (mean age of 50.03±9.55 years). The control group was recruited from the hospital personnel and it consisted of 40 examinees (mean age of 47.20±7.99 years). All patients who participated in the study were diagnosed with depressive disorder using MINI questionnaire, and Hamilton rating scale for depression. Diagnosis of the metabolic syndrome was set by NCEP ATP III criteria. RESULTS: Examinees with depression but without MS had significantly more cortisol concentration when compared to the control group. CRP was significantly higher in the MDD group when compared to the control group and in MDD+MS group when compared to the control group. IL6 serum levels were significantly higher in the MDD group when compared to the healthy control group, and in MDD+MS group when compared to the healthy control group. ACTH had significant independent predictive values for abdominal obesity. Levels of TNF-α were statistically significant independent predictors for hyperglycaemia. Statistically significant predictive values for MDD were found for cortisol, and IL-6. CONCLUSION: Results shown here emphasise the importance of neuroendocrine and inflammatory factors in pathogenesis of depressive disorder and MS. Further prospective research is necessary to clarify possible causal relationship between depression and MS. It is necessary to investigate the possibility of a joint biological mechanism in pathogenesis of these two disorders with the special attention given to the disturbances in the immune system.

Surgical Treatment of Moderate Hallux Valgus: A Comparison of Distal Chevron Metatarsal Osteotomy With and Without Lateral Soft-Tissue Release.

PURPOSE: The purpose of the study was to determine whether lateral soft-tissue release (LSTR) has a beneficial or detrimental effect on the outcome of distal Chevron first metatarsal osteotomy (DCMO) in the treatment of moderate hallux valgus (HV). METHODS: We compared the effect of different surgical treatments in 2 groups of patients: group I (23 patients, 25 feet, average age of 55 [from 43 to 77] years) was subjected to DCMO only, whereas group II (18 patients, 23 feet, average age of 59 [from 52 to 70] years]) was subjected to DCMO with LSTR. The American Orthopaedic Foot and Ankle Society's Hallux Metatarsophalangeal-Interphalangeal scale survey was conducted postoperatively, followed by the brief survey on postoperative patient satisfaction. The patient follow-up period was from 18 to 24 months after surgical treatment, on average. RESULTS: After surgical intervention, both groups of patients presented with an improved HV angle, but there was no significant difference between the groups. However, group II showed significant improvements in medial sesamoid bone position and patient satisfaction scores as compared with group I. CONCLUSION: Our midterm follow-up of surgical treatments for moderate HV deformity suggests that both procedures provide good postoperative results. However, according to our results, DCMO with LSTR provides better results than procedures without LSTR. LEVELS OF EVIDENCE: Therapeutic, Level III: Retrospective comparative study.

HBV and HCV serological monitoring among injection drugs users in opiate substitution treatment in Bosnia and Herzegovina.

INTRODUCTION: Use of intravenous heroin carries a risk of serious medical conditions, including acquiring blood-borne infections. Therefore, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection represent a threat for people who inject drugs (PWID). The objectives of this study were to determine the extent and characteristics of risk factors for acquiring HBV and HCV infection in PWID included in opiate substitution treatment in the southern part of Bosnia and Herzegovina (B&H). METHODOLOGY: The study included 120 adult PWID of both sexes who participated in opiate substitution treatment. All participants were interviewed, and their blood samples were tested for the presence of the surface hepatitis B virus antigen (HBsAg) and hepatitis C virus antibodies (anti-HCV). Prevalence data were obtained and compared to the serological status. RESULTS: HBsAg prevalence among PWID was 0.8% (1/120), whereas seroprevalence of anti-HCV was 52.5% (63/120). PWID exposed to risk-behavior factors (such as unsafe sexual activity, serving prison sentence, and tattooing) were more frequently anti-HCV positive. Sharing drug paraphernalia was found to be the most significant risk factor. The highest predictive values for acquiring HCV-infection were attributed to PWID who used heroin for more than three years and who were unmarried. CONCLUSIONS: HBsAg prevalence among PWID is rare (0.8%), while HCV-infection (52.5%) presents an important health and social issue among PWID in B&H. Sharing drug paraphernalia and intravenous heroin use longer than three years were the most prominent risk-behavior factors among the patients we investigated.

Religiosty and Mental Health in Nursing Students.

BACKGROUND: Young people and nursing students are prone to stress and psychological consequences of it. The aim of the current study was to assess the associations between psychopathology and religiosity in the group of nursing university students. SUBJECTS AND METHODS: The study included 100 nursing students of the Faculty of Health Studies in Mostar. The participants were assessed with the SLC-90-R and Dimensions of Religiosity Questionnaire. Sociodemographic data were also collected. RESULTS: All SCL-90-R subscales negatively correlated with religiosity showing that the strength of religiosity was associated with better mental health of nursing students. Twenty two percent of potential cases of mental disorder were detected based on the GSI cut-off score. Religiosity was a significant predictor of mental disorder in logistic regression based on the GSI. The year of the study and quality of family relations were associated with students' religiosity. Gender, socioeconomic status and parents' education were associated with higher psychopathology scores. CONCLUSION: Religiosity showed to be important factor of resilience for nursing students. Further studies are needed.

Socio-Cultural Effects on Mental Health and Common Chronic Diseases in Primary Care Patients in East and West Mostar, Bosnia and Herzegovina: Preliminary Results.

Since war activities, the previously mixed population of Mostar, Bosnia and Herzegovina, live in segregated parts of the town based on ethnicity. The aim of this study was to examine differences in health risks and health status between populations of the two parts of the town. Health status of 300 randomly selected primary care patients was evaluated by practicing family physicians in two main primary care centers in West and East Mostar. Each group consisted of 150 patients. Data were collected between December 2013 and May 2014. Patients were evaluated for smoking habit, alcohol consumption, body mass index, blood pressure and laboratory measurement of fasting glycemia. Family physicians provided diagnosis of chronic noninfectious diseases (hypertension, diabetes mellitus, cardiovascular disease, malignant disease, depression, and alcoholism). The two groups differed according to age, income, employment status, and rate of alcoholism and hypertension. Alcoholism (OR= 4.105; 95% CI 2.012-8.374) and hypertension (OR=1.972; 95% CI 1.253-3.976) were associated with inhabitants of West Mostar, adjusted for age, employment and income status on logistic regression. In conclusion, ethnic differences between inhabitants of the two parts of the town might influence health outcomes. These are preliminary data and additional studies with larger samples and more specific questions considering nutrition and cultural issues are needed to detect the potential differences between the groups.

Medical students' attitudes towards contraception.

BACKGROUND: The student population is at higher risk of acquiring sexual transmitted diseases (STDs) and accounts for a higher incidence of unplanned pregnancies due to a combination of lifestyle and environmental reasons. AIM: To determine the attitudes of medical students towards contraception. METHODS: A total of 190 students of the School of Medicine of University of Mostar attending four different-academic years participated in this cross-sectional study. Attitudes of participants towards contraception were examined using an anonymous questionnaire. RESULTS: Sexually active students accounted for 61.1% of participants, of which 52.6% regularly used contraception. The most common method of contraception was male condom (90.3%). The main reason for contraception was to avoid pregnancy (64.1%). Students with higher medical education (p<0.001) and students with non-religious views (p=0.004) had positive attitudes towards contraception. There were no gender differences on contraception views. CONCLUSION: Students with higher medical education and those with non-religious views had positive attitudes towards contraception. Therefore, education on contraception assumes its wider use, which is an important measure to reduce the incidence of STDs and unwanted pregnancies in high-risk population.

The impact of socio-economic processes on the health of the adult population.

BACKGROUND: A cross-sectional study in the Primary Care Medical Centre Mostar and Regional Medical Center "Safet Mujic" was conducted. Family physicians randomly surveyed, examined, and analyzed laboratory tests from 300 subjects divided into three age groups from 20-39, 40-54 and 55-65 years, totally 100 subjects. Data for age, sex, smoking status, alcohol consumption, body mass index, blood pressure, blood glucose, triglycerides and cholesterol, and the presence of chronic non-communicable diseases, including diagnosis of depression and the presence of stress were entered in medical records. RESULTS: Levels of cholesterol were significantly higher in rural population as well as among students, and high triglyceride levels most frequently were presented in the student population. A group of farmers had a significantly higher prevalence of hypertension, DM and CVD compared to other investigated groups. The largest number of smokers and people who drink alcohol was present in group with the highest incomes, while obesity was significantly expressed in people with lower incomes. The group of examinees with the highest incomes had the greatest exposure to stress. CONCLUSIONS: Socioeconomic processes have an impact on risk behavior of the adult population, and the presence of a number of chronic diseases that are accompanied with increased laboratory blood glucose, cholesterol and triglycerides levels.