Clinical Significance and Expression Pattern of RIP5 and VGLL4 in Clear Cell Renal Cell Carcinoma Patients Treated with Sunitinib.

While clear cell renal cell carcinoma (ccRCC) is curable, advanced metastatic (mRCC) remains a clinical challenge. We analyzed clinical, pathohistological, and molecular data (Receptor Interacting Protein 5-RIP5 and Vestigial Like Family Member 4-VGLL4 expression) of 55 mRCC patients treated with first-line treatment with sunitinib. The trend of linear increase in the protein expression of RIP5 was observed with the progression of tumor grade. Overall, 80% of RIP5-positive cells were in the control kidneys and high-grade mRCC. On the contrary, RIP5 displayed low expression in grade 2 mRCC (5.63%). The trend of linear decrease in the expression of VGLL4 was observed with the progression of tumor grade. The highest protein expression of VGLL4 was observed in grade 2 (87.82%) in comparison to grade 3 and 4 and control. High expression of RIP5 mRNA was associated with longer first-line overall survival and longer progression-free survival in mRCC. In addition, a high VGLL4 mRNA expression showed better overall survival in patients with ccRCC. In conclusion, high mRNA expression of RIP5 and VGLL4 are important markers of better survival rates in mRCC patients.

THE IMPACT OF SHIFT WORK ON THE METABOLISM AND CIRCADIAN RHYTHM IN NURSES AND MEDICAL TECHNICIANS.

Providing in-patient nursing care inevitably involves shift work and shift patterns have been identified as an important factor in determining well-being and satisfaction among nurses. Shifts of 12 h or longer have become increasingly common for nurses in hospitals in some European countries. Longer shifts offer a potential to benefit from a compressed working week, with fewer work days and more days off-work, lower commuting costs, and increased flexibility. Most people find shift work less desirable compared to standard working hours. A cross-sectional cohort study was conducted at the Mostar University Hospital in 2019. A total of 157 subjects participated in the study, 22 (14%) of which were male (medical technicians) and 135 (86%) female (nurses). The mean age of study subjects was 33.3 years (min=20, max=54, SD=8.033). Results of this study suggested that nurses working irregular rotating shifts, with more family members to look after and more than 18 years of professional experience were affected by sleep disturbances between shifts. The study showed that shift work nurses had significantly higher levels of cortisol and prolactin compared with first-shift nurses/medical technicians. The results of this study are expected to stimulate further studies of sleep disturbances among shift nurses.

The Effect of Shift Work on the Overall Health Status of Hospital-Employed Nursing Staff in Bosnia and Herzegovina: A Cross-Sectional Study.

BACKGROUND: Nursing is a profession frequently organized around shift work in order to guarantee the continuity of care throughout the 24 hours. However, working in shifts is coupled with the desynchronization of circadian rhythms and may result in adverse effects on nurses' health. Our previous work has demonstrated the presence of increased stress levels, reduced coping abilities and diminished life enjoyment in shift work nurses in comparison to those working only in accordance with the daily schedule. Here we aimed to appraise the effects of shift work on their overall health status. SUBJECTS AND METHODS: We used a comparative cross-sectional approach on a sample of 157 hospital nursing professionals at the University Clinical Hospital Mostar. Study subjects were divided into two groups: a total of 51% study subjects were included in a specific type of shift work (i.e., 12-hour day shift / 24 hours off / 12-hour night shift / 48 hours off), while the remaining 49% adhered to the conventional 7-hour daily schedule. The instrument used was a Standard Shiftwork Index (SSI), together with a comprehensive appraisal of participants' socio-demographic characteristics. Descriptive and inferential statistical methods were applied, and statistical significance was set at p≤0.05 (two-sided). RESULTS: The results have shown that nurses in shift work were significantly more burdened with gastrointestinal disturbances (p<0.001); more specifically, there was a higher frequency of appetite loss (p=0.003), heartburn (p=0.03), nausea (p<0.01) and weight gain (p=0.05) when compared to nursing professionals in the day shift. Conversely, there were no statistically significant differences in cardiovascular health between these two groups. In addition, nurses in shift work more frequently presented with headaches (p=0.001) and varicose veins of lower extremities (p=0.037) in comparison to nurses working only in accordance with the daily schedule. CONCLUSIONS: Shift work can adversely influence psychophysical homeostasis, resulting not only in substandard performance of nursing staff, but also potentially hazardous effects on their overall health status. More specifically, we recognized shift work as a substantial risk factor for gastrointestinal and metabolic disorders in nurses; likewise, the increased prevalence of headaches may consequently have a detrimental effect on social and family relationships. All of this should be tackled in a holistic and organized way, together with any additional psychological/sleep issues.

Determinants of the COVID-19 Pandemic in the West Herzegovina Canton.

A study of COVID-19 infected patients was conducted regarding to organic and psychological characteristics. The findings of the study indicate that in the period of the pandemic in 2020, a total of 78 infection cases were confirmed in West Herzegovina Canton. Of the total number of infected, 55.1% are women and 44.9% are men. Of the infected population, 16.7% were hospitalized. By monitoring the COVID-19 disease in West Herzegovina Canton, we conclude how all manifestations of the disease were represented, from asymptomatic, through mild respiratory to the most severe clinical picture with fatal outcomes. The mortality rate in West Herzegovina Canton is 5.1%. The study showed that a total of 28.2% of COVID-19 positive patients before infecting with virus, were most likely to suffer from hypertension, diabetes and malignancies. Furthermore, it is important to emphasize that a total of 71.9% of those infected are without underlying diseases. Also, the results indicate that people with COVID-19 in addition to the characteristic symptoms of the disease (fever, fatigue, cough, etc.) had certain mental ailments such as decreased general mood, increased anxiety, panic attacks, acute stress disorder and others.

The Impact of Shift Work on Psychosocial Functioning and Quality of Life Among Hospital-Employed Nurses: A Cross-Sectional Comparative Study.

BACKGROUND: Approximately 20% of the European labour force is involved in some type of shift work, with nurses being on the forefront. In Bosnia and Herzegovina, a specific work scheme is pervasive in the health care arena, where all nurses involved in shift work are committed to eight night shifts per month - unlike other European countries that restrict the number of night shifts. Accordingly, we aimed to investigate whether such shift work significantly affects psychosocial functioning and the quality of life of hospital nursing personnel in this country. SUBJECTS AND METHODS: A comparative cross-sectional study design was applied on a total of 157 hospital nursing professionals at the University Clinical Hospital Mostar during 2019. Subjects were divided into two groups: a total of 51% study subjects worked in specific shifts (12-hour day shift / 24 hours off / 12-hour night shift / 48 hours off), while 49% subjects worked in accordance with the regular 7-hour daily schedule. Standard Shiftwork Index (SSI) questionnaire was used, alongside comprehensive socio-demographic and quality of life appraisal. Descriptive and inferential statistical methods were applied, and statistical significance was set at p<0.05. RESULTS: This study demonstrated increased amounts of stress, reduced coping abilities and reduced levels of life enjoyment in shift work nurses in comparison to day work nurses. Furthermore, increased anxiety, stress, psychoorganic symptoms and sleep disturbances were significantly more common in shift work hospital nursing staff. In our study, nurses that worked in shifts have experienced negative externalities such as decreased social functioning, as well as reduced family and leisure time. Conversely, significantly higher satisfaction rates with shift work were only shown in regards to compensation. CONCLUSIONS: Our results reveal many detrimental effects of shift work and contribute to the field of research that is still laden with gaps in understanding its exact impact on the overall health of nursing personnel. Going forward, prospective (and even interventional) studies will be needed to disentangle the exact interplay between work-related factors in various health care systems and subsequent psychosocial disorders in health personnel.

Association of erythrocyte sedimentation rate and fibrinogen concentration with metabolic syndrome in schizophrenic patients.

INTRODUCTION: Inflammation can be a process significant to the development of schizophrenia and metabolic disorders that are frequently found in patients suffering from schizophrenia. The aim of this study was to determine the values of erythrocyte sedimentation rate and fibrinogen concentration and to establish their possible association with MS and its components in schizophrenic patients. SUBJECTS AND METHODS: A cross-sectional study was conducted on 200 subjects who were divided into two groups. The study group consisted of schizophrenic patients from the University Clinical Hospital Mostar (n=100), while the control group consisted of healthy subjects who came for systematic medical examinations at the infirmary of the Health Center Mostar (n=100). The diagnosis of MS was made according to NCEP-ATP III criteria, and on that basis subjects from both groups were divided into two subgroups, one with and one without MS. Inflammatory indicators that were determinated were erythrocyte sedimentation rate and fibrinogen concentration. RESULTS: Statistically, MS was significantly more frequent in schizophrenic subjects (46.0%) compared to the control group (29.0%) (p=0.013). Schizophrenic subjects with MS had statistically higher sedimentation rate and fibrinogen concentration compared to the schizophrenic subjects without MS, as well as compared to the control subgroup without MS. The most significant correlations discovered were for the relation of sedimentation rate with systolic (r=0.41) and diastolic (r=0.34) blood pressures. CONCLUSION: Routine monitoring of erythrocyte sedimentation rate and fibrinogen concentration might have an important role in forecasting MS development and consequent adverse cardiovascular events which are the leading cause of mortality in schizophrenic patients.