Covid-19-related stressors, mental disorders, depressive and anxiety symptoms: a cross-sectional, nationally-representative, face-to-face survey in Serbia.

AIM: The Covid-19 pandemic may be associated with an increase in mental disorders and mental distress. However, there are no representative studies testing the impact of stressors directly related to Covid-19. We aimed to determine whether Covid-19-related stressors were associated with mental disorders, depressive and anxiety symptoms in the second year of the pandemic. METHOD: This cross-sectional observational epidemiological survey was conducted from June to October 2021. We interviewed a representative sample of the adult population in Serbia (18-65 years) in the second year of the pandemic, at a time when large parts of the population had been affected by the pandemic in different ways. A multistage probabilistic household sampling of the adult population in 60 municipalities was used. Mental disorders were assessed by in-person interviews using the Mini International Neuropsychiatric Interview. Depressive and anxiety symptoms were measured by PHQ-9 and GAD-7 scales. Covid-19-related stressors (Sars-CoV-2 infection, the infection of a close relative, self-isolation and lack of protective equipment at work), as well as other stressors during the pandemic (not directly related to the risk of the infection), were measured. The associations with mental disorders, depressive and anxiety symptoms were explored through univariable and multivariable regression analyses. RESULTS: In total, 1203 individuals (mean age 43.7 ± 13.6 years, 48.7% male) were interviewed. Most respondents (67.8%) of the sample had already experienced Covid-19-related stressors (20.1% had Sars-CoV-2 infection; 43.2% had a close relative member who had Covid-19; 28.2% reported lack of appropriate protection; 27.5% had been quarantined) and about 50% had already been vaccinated. The prevalence of any mental disorder was 15.2% (95% CI 13.2-17.2): mood disorders 4.6%, anxiety disorders 4.3% and substance use disorders 8.0%. Mean PHQ-9 was 3.2 ± 3.8 and GAD-7 was 2.1 ± 3.1. In this study, one Covid-19 stressor, i.e. lack of protective equipment, was weakly associated with a greater frequency of anxiety disorders (p = 0.023), while the other stressors had significant associations with several groups of mental disorders and symptom levels. CONCLUSIONS: Our study did not provide any evidence that the prevalence of mental disorders exceeds the range of pre-pandemic data reported in the literature. Covid-related stressors, although frequently reported, did not dramatically influence the prevalence of mental disorders. The provision of the appropriate equipment at workplaces might lead to the reduction of anxiety disorders.

The Serbian COVID-19 Stress Scale and vaccine acceptance: is there a place for COVID-19-related distress in explaining attitudes towards vaccination?

OBJECTIVES: Previous research has shown that the COVID-19 Stress Scale (CSS), a measure assessing various dimensions of distress related to the COVID-19 pandemic, is associated with self-protective behaviours; however, it remains unknown whether this distress can be used to predict attitudes towards vaccination. The purpose of this study was to validate the Serbian CSS (Serbian-CSS) and to explore its predictive power over and above certain sociodemographic characteristics, individual difference variables (attitudes and personality) and general distress in relation to COVID-19 vaccine acceptance. STUDY DESIGN: An online cross-sectional study was conducted that targeted users of different social network groups at the beginning of the public COVID-19 vaccination programme in Serbia. METHODS: A large, online study sample (N = 3129) provided self-reported data on COVID-19-related distress, health and sociodemographic indicators, individual difference variables and attitudes towards vaccination. RESULTS: The Serbian-CSS is a valid and reliable instrument that assesses six dimensions of COVID-19 distress. The strongest predictors of vaccine acceptance were attitudes towards immigrants (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] 0.31, 0.41), followed by education (AOR = 1.51, 95% CI 1.27, 1.88) and prepandemic mental health issues (AOR = 1.61, 95% CI 1.30, 2.01). CONCLUSIONS: The level of distress measured by the CSS had a non-substantial contribution to vaccine acceptance, which is probably because of the mild level of distress that was observed at the time of assessment. Public health messaging that relies on the distribution of information is not sufficient to address strongly held beliefs against vaccination. The study provides a benchmark for future cross-cultural research regarding negative affective states associated with the COVID-19 pandemic.

Can social media intervention improve physical activity of medical students?

OBJECTIVES: Physical activity level decreases during young adulthood. As social media are nowadays widely used and are included into many people's daily routines, the interventions on these websites have the possibilities to be integrated into those routines without becoming a burden. The aim of this study was to assess physical activity level among first- and fifth-year medical students and social media intervention with the aim to improve physical activity among them. STUDY DESIGN: Prospective longitudinal study was conducted during October of 2016 at the Faculty of Medicine, University of Belgrade, Serbia. The study included 375 first- and fifth-year students. METHODS: At the baseline, students filled in the questionnaire and were asked to join a Facebook discussion group. The intervention consisted of motivation for physical activity through motivational pictures, texts, and discussions. The second assessment was carried out after one month. Based on the reported physical activity level, students were divided into groups: sufficient (>600 metabolic equivalent [MET]-minutes/week) and insufficient physical activity (≤600 MET-minutes/week). RESULTS: Total of 85.4% of students were sufficiently active at the baseline, whereas 90.4% were sufficiently active after one month. Multivariate logistic regression analysis showed that students who were part of the Facebook group (odds ratio [OR]: 3.51, 95% confidence interval [CI]: 1.46-8.43) and students who had sufficient physical activity at the baseline (OR: 5.44, 95% CI: 2.44-12.13) had a higher likelihood to be sufficiently active after one month. CONCLUSION: Social media are shown to be valuable in health-promoting interventions and can be used for interventions targeting lifestyle change among young adults.

α-Tocopherol Reduces Morphological Changes and Oxidative Stress during Gentamicin-Induced Acute Renal Failure.

We studied the effect of α-tocopherol on gentamicin-induced morphological and functional changes in the kidneys of Wistar rats. Special attention was paid to the ability of α-tocopherol administered in combination with gentamicin to correct ultrastructural changes in the glomerular basal membrane and tubules. Combined treatment with α-tocopherol (100 mg/kg) and gentamicin (100 mg/kg) led to correction of histopathological and biochemical changes and oxidative injury to the kidneys induced by this antibiotic.

Association between FokI, ApaI and TaqI RFLP polymorphisms in VDR gene and Hashimoto's thyroiditis: preliminary data from female patients in Serbia.

Hashimoto's thyroiditis (HT) is the most prevalent autoimmune thyroid disorder caused by an interaction between genes and environmental triggers. Intrathyroid lymphocytic infiltration may lead to progressive destruction of thyroid tissue and consequently to hypothyroidism. Many studies in different populations have shown association between vitamin D receptor (VDR) gene polymorphisms and various autoimmune diseases, including HT. The study included 44 female patients (mean age ± standard deviation 38 ± 5.4) with Hashimoto's thyroiditis and 32 healthy age-matched, sex-matched and geographically matched controls without personal history of autoimmune and endocrine diseases. Genomic DNA was isolated from peripheral blood-EDTA, and the target VDR gene was genotyped by PCR-RFLP technique after VDR-FokI (rs2228570), VDR-ApaI (rs7975232) and VDR-TaqI (rs731236) restriction enzymes digestion. We used spss 20.0 integrated software for data analysis and found a significant difference in the genotype distribution of VDR-FokI polymorphism between patients with HT and controls (P = 0.009). For ApaI and TaqI, we observed a higher frequency of variant allele in patients with HT, which was not significantly different compared to control women (P > 0.05). The current first and preliminary results identified the association between VDR-FokI gene polymorphism and Hashimoto's thyroiditis in Serbian population. Results need to be supported by further investigations that define haplotype patterns for VDR gene polymorphisms in a larger group of HT patients of both sexes.

Is lymphocytic thyroiditis a unique type or merely a type of Hashimoto's thyroiditis?

AIM: Objective of the study was to clarify the role of apoptosis in the pathogenesis of lymphocytic thyroiditis (LT) and the existence of difference between Hashimoto's thyroiditis (HT) and LT. METHODS: We evaluated levels of antithyroglobulin and antithyroperoxidase antibodies, the apoptosis by in situ Cell Death Detection-TUNEL and the expression of Bcl2 and Bax by immunohistochemistry in thyroid tissues from 16 patient with HT, 10 with LT and 10 with euthyroid goiter-EG (control group). RESULTS: It was found that apoptosis of thyrocytes in HT (mean 3.05%, SD 1.29%) and LT (mean 2.70%, SD 1.17%) was statistically significantly higher than EG (mean 0.56%, SD 0.23%), but the difference in the percentage of thyrocytes between HT and LT was not statistically significant. In HT the percentage of apoptotic infiltrating lymphocytes (mean 0.59%, SD 0.23%) was smaller than in EG (mean 2.26%, SD 1.42%), but it showed no significant difference in comparison to LT. The expression of Bax in infiltrating lymphocytes in HT (mean 0.72%, SD 0.34%) was statistically significantly higher than LT (mean 0.11%, SD 0.06%). The level of thyroglobulin was lower in HT compared to LT (P<0.01) and compared to EG (P<0.01). The level of antithyroglobulin/antithyroperoxidase antibodies was higher in HT compared to LT (P<0.01) and compared to EG (P<0.01). There was no statistically significant difference in the level of thyroglobulin and level of antibodies between LT and EG. CONCLUSION: These results suppose that apoptosis represents one of significant mechanisms in the pathogenesis of both HT and LT and that LT probably differs from HT.

Correlated micro-photoluminescence and electron microscopy studies of the same individual heterostructured semiconductor nanowires.

To correlate optical properties to structural characteristics, we developed a robust strategy for characterizing the same individual heterostructured semiconductor nanowires (NWs) by alternating low temperature micro-photoluminescence (µ-PL), low voltage scanning (transmission) electron microscopy and conventional transmission electron microscopy. The NWs used in this work were wurtzite GaAs core with zinc blende GaAsSb axial insert and AlGaAs radial shell grown by molecular beam epitaxy. The series of experiments demonstrated that high energy (200 kV) electrons are detrimental for the optical properties, whereas medium energy (5-30 kV) electrons do not affect the PL response. Thus, such medium energy electrons can be used to select NWs for correlated optical-structural studies prior to µ-PL or in NW device processing. The correlation between the three main µ-PL bands and crystal phases of different compositions, present in this heterostructure, is demonstrated for selected NWs. The positions where a NW fractures during specimen preparation can considerably affect the PL spectra of the NW. The effects of crystal-phase variations and lattice defects on the optical properties are discussed. The established strategy can be applied to other nanosized electro-optical materials, and other characterization tools can be incorporated into this routine.

Peritubular membrane potential in kidney proximal tubular cells of spontaneously hypertensive rats.

Peritubular membrane potential in kidney proximal tubular cells of spontaneously hypertensive rats (SHR-Okamoto strain adult rats) was measured with conventional 3 mol KCl microelectrodes, in vivo. Peritubular cell membrane potential was not different in SHR (-66.5 ± 0.7 mV) as compared with normotensive control Wistar rats (-67.5 ± 1.2 mV). To test the effects of possible altered sodium membrane transport in SHR on proximal tubule peritubular membrane potential, we allowed SHR and control rats to drink 1% NaCl for two weeks. Again, proximal tubule peritubular membrane potential was not different in SHR on 1% NaCl (-67.0 ± 1.0 mV) as compared with control rats on 1% NaCl (-64.7 ± 1.3 mV). From these results we concluded that peritubular membrane potential in kidney proximal tubular cells of SHR was not different from normotensive Wistar control rats, and if some alteration of sodium transport in kidney proximal tubular cells of SHR could exist, that was not possible to evaluate from the measurements of peritubular membrane potential in kidney proximal tubular cells.

Differential expression of KCNQ1 K+ channel in tubular cells of frog kidney.

The aim of this study was to evaluate KCNQ1 K+ channel expression in the frog kidney of Rana esculenta. KCNQ1 K+ channel, also known as KvLQT1, is the pore forming a-subunit of the IKs K+ channel, a delayed rectifier voltage-gated K+ channel, which has an important role in water and salt transport in the kidney and gastrointestinal tract. The expression of KCNQ1 K+ channel along tubular epithelium differs from species to species. In the present study the expression of KCNQ1 K+ channel in the frog kidney has been demonstrated by immunohistochemistry. The presence of KCNQ1 K+ channel was demonstrated in the epithelial cells of distal convoluted tubule and collecting duct. However, the pattern of expression of KCNQ1 K+ channel differs between distal convoluted tubules and collecting duct. All epithelial cells of distal convoluted tubules revealed basolateral expression of KCNQ1 K+ channel. On the contrary, only the single cells of collecting duct, probably intercalated cells, showed diffuse cell surface staining with antibodies against KCNQ1 K+ channel. These findings suggest that KCNQ1 K+ channel has cell-specific roles in renal potassium ion transport.

[Occurrence of bacteriuria in malignant hematologic diseases]. / Ucestalost bakteriurije kod malignih hematoloskih oboljenja.

BACKGROUND: Infection risk with patients suffering from hematological malignant diseases is a result of an interaction between a patient and a host and of a dysfunction of organs. During the evolution, human beings have developed an effective defense mechanism. It was defined with functioning of: 1) skin and mucus membranes, 2) phagocyte cells and 3) humoral and cellular immunity. The patients with malignant hematological diseases are exposed to complex pathogenic processes that disturb their balance, which leads to the occurrence of an infective syndrome. METHODS: In the retrospective study of 422 patients with malign hematological disease, epidemiological-clinical analysis of the infectious syndrome has been carried out. Patients were hospitalized at the Clinic for Hematology--Clinical Center of Sarajevo University, in the period from January 1, 1993 to January 1, 2000. diagnostic protocol included the following procedures: anamnesis, clinical picture, biochemical, cytomorphological, pathohistological, microbiological and radiological test. The goal of work was to determine bacteriuria in case of malign hematological diseases as an accompanying, combined complication during the treatment of these patients. RESULTS: In case of patients that were hospitalized in 1994, bacteriuria was present in the percentage of 56, which is over expected trend line whereas in 2000 it was registered in 20.65% of patients had bacteriuria while 17% of patients had have infection, 28% of patients had bacteriuria while 17% of patients had other infections. In case of patients up to 65 age, bacteriuria was more frequent in female population while in the age of over 65 it was more frequent in male population. Through microbiological analysis of urinary flora, monomicrobial bacteriuria was found in case of 58% patients, and patients were mainly in the initial phase of disease. In case of patients with long treatment with antineoplastic drugs or in the phase of advanced basic process, bacteriurias with polymicrobial character were dominant, which is characteristic of recurrent infections of urinary tract. CONCLUSIONS: The authors came to the conclusion that it is necessary to monitor urine flora with malignant hematological disease patients and by using an adequate treatment to minimize initial infection, relapse and reinfection of urinary tract. Still, it is not clear which is the basic factor initiating the infection of urinary tract--whether it is the prevailing intensity and pathogenic aggressiveness of an agent, or the exposure intensity or a supportive condition of the patient.

[Clinical aspects of multiple myeloma]. / Klinicki aspekt multiplog mijeloma.

This paper is a review of the patients with multiple myeloma, hospitalized at Clinic of Haematology in Sarajevo during the period from 1993 to 1998. This study encircles 45 patients; 18 males (40%) and 27 females (60%). Clinical and laboratory records, etiology, cytomorphology and radiography were analyzed in detail. The age of patients was 59.4 years (both males and females). The trends of disease showed increasing in 1994, 1997 and 1998, comparing it with other haematological malignancies (in 1993 the percent was 5.41, in 1998 was 15.83, and the average level, during the analyzed period, was 11.34%). The patients usually came in the terminal phase and that is the reason why median survival was 12 months. According to the results, the authors make a conclusion that there are some characteristics of this disease in individuals, comparing them with the results shown in relevant studies. They find the explanation in the exposure of the population to the chronic stress and deficit of energy caused by malnutrition during the aggression against Bosnia and Herzegovina.

[The effect of cyclosporine on human endothelial cells in culture]. / Djelovanje ciklosporina a na humane endotelne celije u kulturi.

Cyclosporine A is a selective immunosuppressive agent, which significantly minimises graft versus host disease and graft rejection at transplanted patients. Its pharmacological function is many-sided but it is still the subject of research. The author researched direct acting of Cyclosporine A in the culture of endothelial cells. Homogeneous continuous line of endothelial cells from umbilical line had been exposed to Cyclosporine A in the concentration of 2 mg/ml for seven days. Cyclosporine A inhibited replication and proliferation in the culture of endothelial cells. Some abnormal morphological changes were shown: formation of vesicles, nuclear changes and explicit destruction of the cells. By determination cells' vitality, it was discovered significantly smaller number of cells, in a comparison with control cultures (P < 0.01), while by using of monoclonal antibodies on vWF: Ag, a quantitative change in its expressiveness in relation to the control group was proved.

[Culture of endothelial cells as an in vitro model for experimental and clinical research]. / Kultura endotelne celije kao in vitro model za eksperimentalni i prakticni rad.

Culture of endothelial cell is gotten from human umbilical cord by enzymatic digestion. For the growth of cells in culture, medial RPMI 1640 with 20% mixed human serum (NHS) or 20% fetal calf serum (FCS), endothelial cell growth factor (ECGF) and heparin have been used. Plastic, 0.1% gelatin and fibronectin have been used as a fundament. Immune identification of endothelial cells was culture is performed by monoclonal antibodies on vWF:Ag. Homogeneous cell line in culture might be used as in vitro model in both experimental and practice work.

[Contact sensitization to antioxidants in rubber industry workers]. / Kontaktna senzibilizacija na antioksidantne materije kod radnika u gumarskoj industriji.

The most frequent contact allergens in rubber industry are antioxidants, substances against again of rubber. The aim of the work is determining their role in generating of allergic contact dermatitis (ACD) in rubber industry workers depending on the kind of antioxidants, sex of workerw, lenght of working, pace of work. 68 workers (first group) with contact dermatitic and 40 of healthy workerw (second group) in rubber industry were examined. Patch tests and LIF on 5 antioxidants were done. Positive patch tests had 54,41% workers from first group and 17,50% of workers from second group. Most frequent antioxidant is IPPD (N-isopropyl-N-phenylparaphenylendiamin). More frequent sensitization to this allergen was noticed in women (61,29% : 48,65%). Sensitization to antioxidants was more found in workers with longer working experience. Indoubtful influence of workers place to formation of ACD was determined. The results of LIF are not in complete correlation with patch tests and clinical picture. It is concluded that contact sensitization to antioxidants particularly to IPPD often occurs in rubber industry, as well as depends on the length of exposure, working place, sex etc. In diagnosis of ACD to antioxidants, priority is given to clinical picture and patch tests.

Differential effect of cyclosporin application on epithelial cells of the rat thymus. Immunohistochemical study.

Young adult male Wistar rats were given 30 mg per kg of cyclosporin (CS) for 21 consecutive days. A panel of monoclonal antibodies was used to study the phenotype of thymic epithelial cells. After treatment with CS, subcapsular epithelial cells, although phenotypically similar to medullary epithelial cells, were changed in a similar manner to phenotypically distinct epithelial cells of the deep cortex. These cells became enlarged, stockier and their cytoplasmic prolongations were thicker and coarser compared with control cells and their number was not decreased. In contrast, the number of medullary epithelial cells was markedly reduced, whereby the cells with the most mature phenotype (CK8+10-19- and CK8+10+19-) were the most prominently depleted. No proliferation of thymic epithelial cells was detected as monitored by incorporation of 5-bromodeoxyuridine.

[Open injuries of the knee]. / Otvorene povrede kolena.

The authors discuss the therapeutic approach to 9 cases with open injuries of the knee which they have encountered during the past 5 years. All patients were hospitalized in a state of serious traumatic shock and all had multiple injuries. All 5 cases were operated on within 2--3 hours of the injury. The authors used the following postulates in treating this type of trauma: prevention of traumatic shock, early meticulous primary surgical treatment of the wound, closure of the joint with the drainage of the synovial cavity and periarticular space, strict immobilization, reinacting the extensor mechanism, fixation of the condylar fragment and the administration of antibiotics. The surgical treatment was restricted to only the minimal, patelectomy (3 cases) sec. McLaughlin, and in one case the medial condyle was fixed to the femur. Postoperative infection was not noted. All five patients returned to full working capacity and exhibited only minimal loss of extension at the knee.