Diversity Assessment of the Montenegrin Maize Landrace Gene Pool Maintained in Two Gene Banks.

Due to the loss of agro-biodiversity, there is a strong effort to find apparent and efficient mechanisms for the conservation and sustainable use of genetic diversity. A joint monitoring of the diversity and collections structure of the Montenegrin maize landraces conserved in the Serbian (MRIZPGB) and Montenegrin (MGB) gene banks has been conducted in order to improve the composition of the collections and to identify and eliminate possible redundancy. Based on a separate analysis of white- and yellow-orange maize landraces, it can be concluded that the diversity and evolution of distinct maize landraces grown and collected in Montenegro have been simultaneously shaped by both environmental (i.e., natural selection) and socially driven factors (farmers' selection, migration and colonization processes of the human population). Although it has been determined that the authenticity and variability of the Montenegrin maize landraces gene pool have largely been preserved in the MRIZPGB collection, a significant amount of redundancy was observed. The obtained results will contribute to the cost-efficient conservation of the maize gene pool in the Montenegrin and Serbian gene banks. The recognized and well-preserved original variability of the MRIZPGB and MGB Montenegrin gene pool represents a valuable source for pre-breeding activities on broadening the white and flint maize breeding programmes under temperate conditions.

The Association of Polymorphisms in Nrf2 and Genes Involved in Redox Homeostasis in the Development and Progression of Clear Cell Renal Cell Carcinoma.

Deleterious effects of SNPs found in genes encoding transcriptional factors, as well as antioxidant and detoxification enzymes, are disputable; however, their functional significance seems to modify the risk for clear cell renal cell carcinoma (ccRCC) development and progression. We investigated the effect of specific Nrf2, SOD2, GPX1 gene variants and GSTP1ABCD haplotype on ccRCC risk and prognosis and evaluated the association between GSTP1 and regulatory (JNK1/2) and executor (caspase-3) apoptotic molecule expression in ccRCC tissue samples and the presence of GSTP1 : JNK1/2 protein : protein interactions. Genotyping was performed in 223 ccRCC patients and 336 matched controls by PCR-CTTP and qPCR. Protein expression was analyzed using immunoblot, while the existence of GSTP1 : JNK1 protein : protein interactions was investigated by immunoprecipitation experiments. An increased risk of ccRCC development was found among carriers of variant genotypes of both SOD2 rs4880 and GSTP1 rs1695 polymorphisms. Nrf2 rs6721961 genetic polymorphism in combination with both rs4880 and rs1695 showed higher ccRCC risk as well. Haplotype analysis revealed significant risk of ccRCC development in carriers of the GSTP1C haplotype. Furthermore, GSTP1 variant forms seem to affect the overall survival in ccRCC patients, and the proposed molecular mechanism underlying the GSTP1 prognostic role might be the presence of GSTP1 : JNK1/2 protein : protein interactions.

Uptake of Health Care Services by Refugees: Modelling a Country Response to a Western Balkan Refugee Crisis.

Planning and adjusting health capacities to meet the needs of refugees is a constant issue for transit and destination countries following the 2015/2016 Western Balkans refugee crisis. Understanding this crisis is important for taking the right steps in the future. The study informs about the prediction of the refugees' health needs and demands for services in correspondence to political decision-making during 2015/2016 Western Balkan Refugee Crisis. Time series analysis, linear regression, and correlation analyses modelled the weekly flux of arrivals of more than half a million refugees to Serbia and the European Union, changes in the utilization of health care services, and disease diagnoses. With strategic planning, in the event of a recurrence of the refugee crises, the demand for health care services in the transit country could increase by 63 (95% CI: 21-105) for every additional 1000 refugees.

Prevalence and Predictors of Violence Victimization and Violent Behavior among Youths: A Population-Based Study in Serbia.

The study identifies the prevalence of violence victimization and the perpetration among youths, and explores the determinants and predictors using a socio-ecological model. The data of 36 variables from a representative sample of 1722 persons, ages 15-24 years, from the National Health Survey of Serbia in 2013, were analyzed by a multivariate logistic regression modeling. The study shows that 13.4% of youths experienced multi-victimization, while 10.4% were perpetrators of violence. Up to one-third of the victims were violence perpetrators. A small percentage of victims seek family and community support. Predictors of violence among youths were: male sex, households with fewer members, urban settlements, violence perpetration, self-assessed health as poor, lack of close friends and perception that it was difficult to obtain the assistance needed. Predictors of youth violence highlighted the need to improve health education, social support and community regulations, as well as strengthen the promotion of gender equality and a healthy environment.

Positive parenting attitudes and practices in three transitional Eastern European countries: Bosnia and Herzegovina, Macedonia and Serbia.

OBJECTIVES: To identify potential predictors of using only non-violent forms of discipline for children aged 2-14 years and of being against physical punishment among Roma and non-Roma parents/caregivers in Eastern European countries with similar cultural-historical backgrounds. METHODS: UNICEF Multiple Indicator Cluster Survey data collected in 2010-2011 in Bosnia and Herzegovina, Macedonia and Serbia (total of 9973 respondents) were analysed using multivariate logistic regression modelling with receiver operating characteristic analysis. RESULTS: Approximately 27 % of the respondents practiced only non-violent child discipline. Roma children experienced only non-violent discipline less than half as often as their non-Roma counterparts. Household wealth index and child sex were significant predictors of positive parenting attitudes and practice. For Roma respondents, rural residence also contributed to being against physical punishment. CONCLUSIONS: Parents\caregivers from more affluent households are more likely than those who are less affluent to be against physical punishment of children and are more likely to practice only non-violent discipline. Evidence-based interventions are required to support existing positive forms of child rearing. These should target less affluent households from Roma settlements in the studied countries.

High rate of burnout among anaesthesiologists in Belgrade teaching hospitals: Results of a cross-sectional survey.

BACKGROUND: Decisions by anaesthesiologists directly impact the treatment, safety, recovery and quality of life of patients. Physical or mental collapse due to overwork or stress (burnout) in anaesthesiologists may, therefore, be expected to negatively affect patients, departments, healthcare facilities and families. OBJECTIVES: To evaluate the prevalence of burnout among anaesthesiologists in Belgrade public teaching hospitals. DESIGN: A cross-sectional survey. SETTING: Anaesthesiologists in 10 Belgrade teaching hospitals. MAIN OUTCOME MEASURES: Burnout was assessed using Maslach Burnout Inventory-Human Services Survey. RESULTS: The response rate was 76.2% (205/272) with the majority of respondents women (70.7%). The prevalence of total burnout among anaesthesiologists in Belgrade teaching hospitals was 6.34%. Measured level of burnout as assessed by high emotional exhaustion, high depersonalisation and low personal accomplishment was 52.7, 12.2 and 28.8%, respectively. More than a quarter of the studied population responded in each category with symptoms of moderate burnout. We detected that sex, additional academic education, marital status and working conditions were risk factors for emotional exhaustion and depersonalisation. Ageing increased the likelihood of burnout by 21.3% with each additional year. Shorter professional experience and increased educational accomplishment increased the risk of total burnout by 272%. CONCLUSION: Burnout rates in Belgrade teaching hospitals among anaesthesiologists are higher than in foreign hospitals. Emotional and/or physical breakdowns can have serious effects when these individuals care for patients in extremely stressed situations that may occur perioperatively. Causes for burnout should be examined more closely and means implemented to reverse this process.

Training hospital managers for strategic planning and management: a prospective study.

BACKGROUND: Training is the systematic acquisition of skills, rules, concepts, or attitudes and is one of the most important components in any organization's strategy. There is increasing demand for formal and informal training programs especially for physicians in leadership positions. This study determined the learning outcomes after a specific training program for hospital management teams. METHODS: The study was conducted during 2006 and 2007 at the Centre School of Public Health and Management, Faculty of Medicine, University of Belgrade and included 107 participants involved in the management in 20 Serbian general hospitals. The management teams were multidisciplinary, consisting of five members on average: the director of the general hospital, the deputy directors, the head nurse, and the chiefs of support services. The managers attended a training program, which comprised four modules addressing specific topics. Three reviewers independently evaluated the level of management skills at the beginning and 12 months after the training program. Principal component analysis and subsequent stepwise multiple linear regression analysis were performed to determine predictors of learning outcomes. RESULTS: The quality of the SWOT (strengths, weaknesses, opportunities and threats) analyses performed by the trainees improved with differences between 0.35 and 0.49 on a Likert scale (p < 0.001). Principal component analysis explained 81% of the variance affecting their quality of strategic planning. Following the training program, the external environment, strategic positioning, and quality of care were predictors of learning outcomes. The four regression models used showed that the training program had positive effects (p < 0.001) on the ability to formulate a Strategic Plan comprising the hospital mission, vision, strategic objectives, and action plan. CONCLUSION: This study provided evidence that training for strategic planning and management enhanced the strategic decision-making of hospital management teams, which is a requirement for hospitals in an increasingly competitive, complex and challenging context. For the first time, half of state general hospitals involved in team training have formulated the development of an official strategic plan. The positive effects of the formal training program justify additional investment in future education and training.

First- and fifth-year medical students' intention for emigration and practice abroad: a case study of Serbia.

Health worker migration is causing profound health, safety, social, economic and political challenges to countries without special policies for health professionals' mobility. This study describes the prevalence of migration intentions among medical undergraduates, identifies underlying factors related to migration intention and describes subsequent actions in Serbia. Data were captured by survey of 938 medical students from Belgrade University (94% response rate), representing two thirds of matching students in Serbia stated their intentions, reasons and obstacles regarding work abroad. Statistical analyses included descriptive statistics and a sequential multivariate logistic regression. Based on descriptive and inferential statistics we were able to predict the profile of first and fifth year medical students who intend or have plans to work abroad. This study contributes to our understanding of the causes and correlates of intent to migrate and could serve to raise awareness and point to the valuable policy options to manage migration.

Maternal satisfaction with organized perinatal care in Serbian public hospitals.

BACKGROUND: Understanding the experiences and expectations of women across the continuum of antenatal, perinatal, and postnatal care is important to assess the quality of maternal care and to determine problematic areas which could be improved. The objective of this study was to identify the factors associated with maternal satisfaction with hospital-based perinatal care in Serbia. METHODS: Our survey was conducted from January 2009 to January 2010 using a 28-item, self-administered questionnaire. The sample consisted of 50% of women who expected childbirths during the study period from all 76 public institutions with obstetric departments in Serbia. The following three composite outcome variables were constructed: satisfaction with technical and professional aspects of care; communication and interpersonal aspects of care; and environmental factors. RESULTS: We analyzed 34,431 completed questionnaires (84.2% of the study sample). The highest and lowest average satisfaction scores (4.43 and 3.25, respectively) referred to the overall participation of midwives during delivery and the quality of food served in the hospital, respectively. Younger mothers and multiparas were less concerned with the environmental conditions (OR = 0.55, p = 0.006; OR = 1.82, p = 0.004). Final model indicated that mothers informed of patients' rights, pregnancy and delivery through the Maternal Counseling Service were more likely to be satisfied with all three outcome variables. The highest value of the Pearson's coefficient of correlation was between the overall satisfaction score and satisfaction with communication and interpersonal aspects of care. CONCLUSIONS: Our study illuminated the importance of interpersonal aspects of care and education for maternal satisfaction. Improvement of the environmental conditions in hospitals, the WHO program, Baby-friendly Hospital, and above all providing all pregnant women with antenatal education, are recommendations which would more strongly affect the perceptions of quality and satisfaction with perinatal care in Serbian public hospitals by women.

Concordant pressure paresthesia during interlaminar lumbar epidural steroid injections correlates with pain relief in patients with unilateral radicular pain.

BACKGROUND: Transforaminal and interlaminar epidural steroid injections are commonly used interventional pain management procedures in the treatment of radicular low back pain. Even though several studies have shown that transforaminal injections provide enhanced short-term outcomes in patients with radicular and low back pain, they have also been associated with a higher incidence of unintentional intravascular injection and often dire consequences than have interlaminar injections. OBJECTIVES: We compared 2 different approaches, midline and lateral parasagittal, of lumbar interlaminar epidural steroid injection (LESI) in patients with unilateral lumbosacral radiculopathic pain. We also tested the role of concordant pressure paresthesia occurring during LESI as a prognostic factor in determining the efficacy of LESI. STUDY DESIGN: Prospective, randomized, blinded study. SETTING: Pain management center, part of a teaching-community hospital in a major metropolitan US city. METHODS: After Institutional Review Board approval, 106 patients undergoing LESI for radicular low back pain were randomly assigned to one of 2 groups (53 patients each) based on approach: midline interlaminar (MIL) and lateral parasagittal interlaminar (PIL). Patients were asked to grade any pressure paresthesia as occurring ipsilaterally or contralaterally to their "usual and customary pain," or in a distribution atypical of their daily pain. Other variables such as: the Oswestry Disability Index questionnaire, pain scores at rest and during movement, use of pain medications, etc. were recorded 20 minutes before the procedure, and on days 1, 7, 14, 21, 28, 60, 120, 180 and 365 after the injection. RESULTS: Results of this study showed statistically and clinically significant pain relief in patients undergoing LESI by both the MIL and PIL approaches. Patients receiving LESI using the lateral parasagittal approach had statistically and clinically longer pain relief then patients receiving LESI via a midline approach. They also had slightly better quality of life scores and improvement in everyday functionality; they also used less pain medications than patients receiving LESI using a midline approach. Furthermore, patients in the PIL group described significantly higher rates of concordant moderate-to-severe pressure paresthesia in the distributions of their "usual and customary pain" compared to the MIL group. In addition, patients who had concordant pressure paresthesia and no discordant pressure paresthesia (i.e., "opposite side or atypical") during interventional treatment had better and longer pain relief after LESI. Two patients from each group required discectomy surgery in the one-year observation period. LIMITATIONS: The major limitation of this study is that we did not include a transforaminal epidural steroid injection group, since that is one of the approaches still commonly used in contemporary pain practices for the treatment of low back pain with unilateral radicular pain. CONCLUSIONS: This study showed that the lateral parasagittal interlaminar approach was more effective than the midline interlaminar approach in targeting low back pain with unilateral radicular pain secondary to degenerative lumbar disc disease. It also showed that pressure paresthesia occurring ipsilaterally during an LESI correlates with pain relief and may therefore be used as a prognostic factor.

Physician and nurse supply in Serbia using time-series data.

BACKGROUND: Unemployment among health professionals in Serbia has risen in the recent past and continues to increase. This highlights the need to understand how to change policies to meet real and projected needs. This study identified variables that were significantly related to physician and nurse employment rates in the public healthcare sector in Serbia from 1961 to 2008 and used these to develop parameters to model physician and nurse supply in the public healthcare sector through to 2015. METHODS: The relationships among six variables used for planning physician and nurse employment in public healthcare sector in Serbia were identified for two periods: 1961 to 1982 and 1983 to 2008. Those variables included: the annual total national population; gross domestic product adjusted to 1994 prices; inpatient care discharges; outpatient care visits; students enrolled in the first year of medical studies at public universities; and the annual number of graduated physicians. Based on historic trends, physician supply and nurse supply in the public healthcare sector by 2015 (with corresponding 95% confidence level) have been modeled using Autoregressive Integrated Moving Average (ARIMA) / Transfer function (TF) models. RESULTS: The ARIMA/TF modeling yielded stable and significant forecasts of physician supply (stationary R2 squared = 0.71) and nurse supply (stationary R2 squared = 0.92) in the public healthcare sector in Serbia through to 2015. The most significant predictors for physician employment were the population and GDP. The supply of nursing staff was, in turn, related to the number of physicians. Physician and nurse rates per 100,000 population increased by 13%. The model predicts a seven-year mismatch between the supply of graduates and vacancies in the public healthcare sector is forecasted at 8,698 physicians - a net surplus. CONCLUSION: The ARIMA model can be used to project trends, especially those that identify significant mismatches between forecasted supply of physicians and vacancies and can be used to guide decision-making for enrollment planning for the medical schools in Serbia. Serbia needs an inter-sectoral strategy for HRH development that is more coherent with healthcare objectives and more accountable in terms of professional mobility.

The importance of family relations for cannabis users: the case of serbian adolescents.

BACKGROUND: Adolescence is transitional stage of physical and mental human development occuring between childhood and adult life. Social interactions and environmental factors together are important predictors of adolescent cannabis use. This study aimed to examine the relationship between the social determinants and adolescents behavior with cannabis consumption. METHODS: A cross sectional study as part of the European School Survey Project on Alcohol and other Drugs was conducted among 6.150 adolescents aged 16 years in three regions of Serbia, and three types of schools (gymnasium, vocational - professional, and vocational - handicraft) during May - June 2008. A multivariate logistic regression analysis was carried out to obtain adjusted odds ratios with 95% confidence intervals in which the dependent variable was cannabis consumption non-user and user. RESULTS: Among 6.7% of adolescents who had tried cannabis at least one in their lives, boys were more involved in cannabis use than girls, especially boys from gymnasium school. Well off family, lower education of mother, worse relations with parents were significantly associated with cannabis use (P < 0.05). Behaviors like skipping from schools, frequent evening outs, and playing on slot machines were also related to cannabis use (P < 0.05). CONCLUSIONS: The study confirmed the importance of family relationship development. Drug use preventive programmes should include building interpersonal trust in a family lifecycle and school culture.

Hospitalizations due to spontaneous intracerebral hemorrhage in the region of Nis (Serbia): 11-year time-series analysis.

BACKGROUND: The study of seasonal variability of intracerebral hemorrhage (ICH) occurrence may contribute to a better understanding of the nature of this disease and open up new perspectives in its prevention. The aim of this study was to test seasonal patterns in the number of admissions of ICH patients and determine which months have maximal and minimal number of admissions. METHODS: The main data source for this study was a hospital-based registry at the Clinic of Neurology in Nis, Serbia. During the studied period (1997-2007) a total of 1569 ICH patients were registered. Time series, consisting of the monthly number of hospitalized patients, for the 128 months of the study duration, has been successfully modeled using the multiplicative Auto Regressive Integrated Moving Average (ARIMA) model. RESULTS: Using the maximum likelihood method, utilizing Melrad's algorithm, the parameters of this ARIMA model have been calculated: constant (estimate 12.068, p<0.001), auto regressive-AR(1) (estimate 0.866, p<0.001), moving average-MA(1) (estimate 0.775, p<0.001), seasonal moving average-SMA(12) (estimate -0.198, p=0.036). ARIMA modeling has been successful and showed that there is a clear seasonal pattern in the data analyzed. CONCLUSION: Based on the seasonal multiplicative ARIMA model and the seasonal time series decomposition, we showed that, in the period covered by the study, the peak of admissions occurred in March, and the trough of admissions was found in August.

Competencies gap of management teams in primary health care.

BACKGROUND: Health workforce competencies are considered crucial for attaining high-quality health care in the current market principles approach to the provision of health services. This study explored the competencies and the perceived competence gap of management personnel in public primary healthcare. METHODS: During 2007 and 2008, 14 management teams of Belgrade primary health-care centres were questioned before and after management training in six competency categories. Competency mean differences (95% confidence interval) by gender, educational level, experience and position were analysed by Leven, Snedecor or Welch statistics, and Student's t-test for comparison of two independent samples. Mixed Model Analysis clarified possible interactions of the managers' baseline characteristics and competency task ratings. Differences between team ratings were analysed by analysis of variance (ANOVA) or the Kruskal-Wallis test. The General Linear Model Repeated Measures Analysis determined interactions and competency gap changes. Differences were statistically significant at P ≤ 0.05. RESULTS: Female managers developed higher competency levels after training in communication skills and problem solving. Top managers rated assessing performance of higher importance, while chief nurses emphasized the importance of leading. Before training, the estimated competency gap was generally the highest in assessing performance (6.29), followed by team building (5.81) and planning and priority setting (5.70). Five months after training, the highest gap remained in assessing performance, although it was reduced considerably to 3.18 (P < 0.0005). CONCLUSIONS: Managers rated core competencies as highly important. The reduction in competency gaps can be significant through training. However, assessing performance remained a relatively high weakness among managers.

Buprenorphine enhances and prolongs the postoperative analgesic effect of bupivacaine in patients receiving infragluteal sciatic nerve block.

BACKGROUND: Results from previous studies have shown favorable effects from the addition of buprenorphine to local anesthetics used for interscalene or axillary perivascular brachial plexus blocks. The main objective of the current study was to determine whether addition of buprenorphine could enhance bupivacaine analgesia after infragluteal sciatic nerve block. METHODS: One hundred and three consenting adult patients for elective foot and ankle outpatient surgeries were prospectively assigned randomly, in double-blind fashion, to one of three groups. Group 1 received 0.5% bupivacaine with epinephrine 1:200,000 for infragluteal sciatic block plus 1 ml normal saline intramuscularly. Group 2 received bupivacaine sciatic block along with intramuscular buprenorphine (0.3 mg). Group 3 received bupivacaine plus buprenorphine for infragluteal sciatic block and 1 ml normal saline intramuscularly. RESULTS: Although patients receiving buprenorphine either for sciatic block or intramuscularly had less pain in the postanesthesia care unit compared with patients receiving only bupivacaine, the individual pair-wise comparison of the analysis of variance model showed no statistical difference. However, only buprenorphine added to bupivacaine for sciatic block prolonged postoperative analgesia. Patients receiving a combination of buprenorphine and bupivacaine for sciatic block had lower numeric rating pain scores and received less opioid medication at home than patients in the other two groups. CONCLUSIONS: The results show that buprenorphine may enhance and prolong the analgesic effect of bupivacaine when used for sciatic nerve blocks in patients undergoing foot and ankle surgery under general anesthesia but does not do so to the extent shown in previous studies using brachial plexus models with mepivacaine and tetracaine.

Weekly variation of hospital admissions for stroke in Nis (Serbia).

OBJECTIVES: Weekly variability in stroke occurrence could be related to the change in behaviors of patients or medical personnel that occur during certain periods of the week. The aim of the present study was to examine the weekly variation in hospital admissions for stroke in Nis (Serbia), as well as to investigate how the demographic factors influenced these changes. PATIENTS AND METHODS: The main data source for this study was the Nis Stroke Registry. During the study period (1996-2007) a total of 9675 stroke patients were registered. According to stroke subtypes, all registered patients were divided into three groups: patients with subarachnoid hemorrhage (SAH) (438 or 4.5%), patients with intracerebral hemorrhage (ICH) (1576 or 16.3%) and patients with ischemic stroke (IS) (6946 or 71.8%). Analyses were conducted separately for SAH, ICH and IS. Each stroke type was stratified by gender, age group and education level. RESULTS: We have showed that there is a significant weekly variability in the number of SAH (p=0.028) and IS (p<0.001) admissions, with the minimum number of admissions on Sundays (39.27 and 14.04% less than expected), and the maximum one on Tuesdays (21.46% more than expected) and Wednesdays (10.96% more than expected), respectively. We have also registered more SAH (p=0.015) and IS (p<0.001) admissions on weekdays than on weekend days. CONCLUSION: Results of this hospital-based study confirm that there is a pattern in the variation of the number of stroke admissions on the weekly level. Reasons for the weekly variation of hospital admissions for stroke cannot be determined from the present study.

Hospital management training and improvement in managerial skills: Serbian experience.

OBJECTIVES: The purpose of this study was to analyze the improvement of managerial skills of hospitals' top managers after a specific management training programme, and to explore possible predictors and relations. METHODS: The study was conducted during the years 2006 and 2007 with cohort of 107 managers from 20 Serbian general hospitals. The managers self-assessed the improvement in their managerial skills before and after the training programme. RESULTS: After the training programme, all managers' skills had improved. The biggest improvement was in the following skills: organizing daily activities, motivating and guiding others, supervising the work of others, group discussion, and situation analysis. The least improved were: applying creative techniques, working well with peers, professional self-development, written communication, and operational planning. Identified predictors of improvement were: shorter years of managerial experience, type of manager, type of profession, and recognizing the importance of the managerial skills in oral communication, evidence-based decision making, and supervising the work of others. CONCLUSIONS: Specific training programme related to strategic management can increase managerial competencies, which are an important source of competitive advantage for organizations.

Serbia within the European context: An analysis of premature mortality.

BACKGROUND: Based on the global predictions majority of deaths will be collectively caused by cancer, cardiovascular diseases, and traffic accidents over the coming 25 years. In planning future national health policy actions, inter - regional assessments play an important role. The purpose of the study was to analyze similarities and differences in premature mortality between Serbia, EURO A, EURO B, and EURO C regions in 2000. METHODS: Mortality and premature mortality patterns were analysed according to cause of death, by gender and seven age intervals. The study results are presented in relative (%) and absolute terms (age-specific and age-standardized death rates per 100,000 population, and age-standardized rates of years of life lost - YLL per 1,000). Direct standardization of rates was undertaken using the standard population of Europe. The inter-regional comparison was based on a calculation of differences in YLL structures and with a ratio of age-standardized YLL rates per 1,000. A multivariate generalized linear model was used to explore mortality of Serbia and Europe sub-regions with ln age-specific death rates. The dissimilarity was achieved with a p

Expression of Th1 and Th17 cytokines and transcription factors in multiple sclerosis patients: does baseline T-bet mRNA predict the response to interferon-beta treatment?

We studied the effect of one-year interferon (IFN)-beta treatment on the in vivo mRNA expression of IFN-gamma, interleukin (IL)-17, T-bet and RoR-gammat, on peripheral blood mononuclear cells (PBMC) from 36 multiple sclerosis (MS) patients. In the total MS group, IFN-beta induced decrease in mRNA levels of IFN-gamma and T-bet (p<0.0001), while the levels of IL-17 and RoR-gammat remained similar. In both responders and non-responders, IFN-beta induced significant decrease of IFN-gamma (p<0.0001 and p=0.011, respectively), while decrease in T-bet was detected only in responders (p<0.0001). Higher pre-treatment T-bet allowed prediction of the clinical response in the first year (beta=0.601, p=0.036). Our preliminary findings suggest that T-bet expression might be a potential prognostic marker of treatment response to IFN-beta in MS.