The Expression of Connexin 37, 40, 43, 45 and Pannexin 1 in the Early Human Retina and Choroid Development and Tumorigenesis.

The expression pattern of Connexins (Cx) 37, 40, 43, 45 and Pannexin 1 (Pnx1) was analyzed immunohistochemically, as well as semi-quantitatively and quantitatively in histological sections of developing 8th- to 12th-week human eyes and postnatal healthy eye, in retinoblastoma and different uveal melanomas. Expressions of both Cx37 and Cx43 increased during development but diminished in the postnatal period, being higher in the retina than in the choroid. Cx37 was highly expressed in the choroid of retinoblastoma, and Cx43 in epitheloid melanoma, while they were both increasingly expressed in mixoid melanoma. In contrast, mild retinal Cx40 expression during development increased to strong in postnatal period, while it was significantly higher in the choroid of mixoid melanoma. Cx45 showed significantly higher expression in the developing retina compared to other samples, while it became low postnatally and in all types of melanoma. Pnx1 was increasingly expressed in developing choroid but became lower in the postnatal eye. It was strongly expressed in epithelial and spindle melanoma, and particularly in retinoblastoma. Our results indicate importance of Cx37 and Cx40 expression in normal and pathological vascularization, and Cx43 expression in inflammatory response. Whereas Cx45 is involved in early stages of eye development, Pnx1might influence cell metabolism. Additionally, Cx43 might be a potential biomarker of tumor prognosis.

Religiousness, Anxiety and Depression in Patients with Glaucoma, Age-Related Macular Degeneration and Diabetic Retinopathy.

BACKGROUND: Many chronic medical conditions such as glaucoma, senile macular degeneration and diabetic retinopathy are further complicated by emotional and psychological disorders. Religiousness represents a part of a social culture and has a significant role in the prevention of mental difficulties of the patients, especially those belonging to older population. The aim of this study was to investigate the connection between religiousness, anxiety, and depression in patients with glaucoma, age-related macular degeneration and diabetic retinopathy and to test their connection related to different diagnosis. SUBJECTS AND METHODS: This cross-sectional study included 163 patients divided into three groups (glaucoma group, senile macular degeneration group and diabetic retinopathy group). Respondents voluntarily agreed to participate in the study and with assistance they fully completed the Scale of Religiousness, Hospital Anxiety and Depression Scale, General Health Questionnaire and demographic information (age, gender, education, employment and marital status). RESULTS: The results showed noticeable religiosity of the respondents (M=18.31, SD=5.28), but also the presence of anxiety (M=7.55, SD=3.73), especially in patients with glaucoma, as well as impaired mental health in AMD patients (M=19.56, SD=4.14). No differences were found in the severity of anxiety, depression, general health and religiosity between groups, but the presence of depression in subjects with age-related macular degeneration significantly affects the level of religiosity (p=0.032). CONCLUSION: These results unequivocally point to the need for further research and raising awareness of all health professionals about the importance of a holistic approach to the patient regardless of his diagnosis in order to identify the possible effective ways to deal with chronic disease considering all levels of patient's needs.

Fear of Blindness in Patients Undergoing Cataract Surgery.

BACKGROUND: Fear is a negative emotion induced by the threat of danger, pain and harm. Cataract surgery is one of the most performed surgeries in the world. The aim of this study was to investigate and analyze the predominant fears in patients undergoing cataract surgery. SUBJECTS AND METHODS: In this cross-sectional study 152 patients were examined. Self-designed questionnaires to examine emotions of the fear, anxiety, nervousness frequency gratitude was used and insecurity immediately before cataract surgery. We also examined what the greatest fear during the cataract surgery was. The fear of blindness was compared with other life fears such as cancer, memory loss, AIDS, stroke and heart attack. The presence of fear was compared in patients having had previous cataract surgery with those undergoing their first cataract surgery. Including criteria were adults with senile cataract. Excluding criteria was ocular co-morbidity, psychiatric disorders, inability to read, deafness and surgery under general anesthesia. Completed questionnaires were analyzed. Pearson's chi-squared test was used. RESULTS: Fear was the most frequent emotion before cataract surgery, present in 60.5% patients. Fear of blindness was the greatest fear during cataract surgery in 55.3% of patients. There was no statistically significant difference in fear in patients having undergone their first cataract surgery and patients before their second cataract surgery (p<0.05). CONCLUSION: Fear is the predominant emotion before cataract surgery which is in correlation to the leading life fear - fear of blindness. Good preoperative preparation and a trusting doctor-patient relationship are important for reducing the fear of the procedure.

Analysis of association of risk factors for age-related macular degeneration.

PURPOSE: To evaluate the significance of risk factors and analyze their interrelationship in developing age-related macular degeneration (AMD). MATERIALS AND DESIGN: This is a multicenter, cross-sectional study conducted in eight ophthalmology centers in Europe. The STARS (Simplified Thea AMD Risk-Assessment Scale) questionnaire was used to assess 12 risk factors grouped in four major categories. We used Welch's t-test/F ratios to determine statistically significant changes. The principal component analysis was done to investigate the association between risk factors. RESULTS: There were 3297 participants included in our data analysis. Nineteen percent of patients had a high risk of developing AMD, whilst 45.92% and 34.85% had moderate and small risk, respectively. Atherosclerosis appeared as the most relevant risk indicator for AMD development (Cohen's d = 0.861). Tukey's post hoc analysis of the smoking variable showed that ex-smokers (p < 0.001) have a significantly high risk of developing AMD. The Welch's t-test showed pseudophakic patients have a higher risk of developing AMD than phakic ones. Then, we conducted the principal component analysis, which revealed a significant connection between smoking and male gender and between smoking and atherosclerosis. Pseudophakic patients were generally older and had more often myocardial infarction as compared to phakic patients. We showed that higher BMI, history of arterial hypertension, hypercholesterolemia, and atherosclerosis tend to occur together as risk factors for AMD. CONCLUSION: Risk factors evaluated in our study should be considered for the development of AMD.

Self-Esteem, Anxiety, and Depression in Older People in Nursing Homes.

BACKGROUND: Social environment and type of care may influence mental health in late life. The aim of this study was to assess the associations between depression, anxiety, and self-esteem in older people. METHODS: The study evaluated mental health in people older than 65 years of age in Zadar County, Croatia. The participants were interviewed using the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Rosenberg Self-Esteem Scale. Multiple linear regressions were used to assess the correlations between depression, anxiety, and self-esteem. RESULTS: Compared with elderly people living in their own homes, elderly people in nursing homes reported lower self-esteem, higher depression, and higher anxiety. The level of self-esteem decreased with increased levels of depression. Anxiety was significantly associated with depression, while depression strongly increased with an increase in anxiety. Older age was associated with depression, while widowhood was a negative predictor of self-esteem. Institutionalization was borderline significantly associated with anxiety, while gender was associated with anxiety. CONCLUSIONS: The study found associations between self-esteem, anxiety, and depression in the elderly. The strategy of humanization in nursing care for older people should be applied equally in nursing homes and in community-dwelling states. Public health programs aimed at maintaining the mental health of older people are needed.

Pre-Vaccination COVID-19 Vaccine Literacy in a Croatian Adult Population: A Cross-Sectional Study.

Despite world-level efforts and the endeavors of scientists and medical professionals in suppressing the COVID-19 pandemic, inadequate levels of vaccine literacy of the general population can represent a grave obstacle. The aim of this study was to evaluate COVID-19 vaccine literacy in the Croatian adult general population before vaccination began. The specific objectives were to test differences regarding socio-demographic characteristics and to examine perceptions and attitudes about vaccination against COVID-19 considering the level of VL against COVID-19. A cross-sectional study with a translated and psychometrically tested questionnaire was conducted in 1227 participants before the start of vaccination, from 15 to 31 January 2021. The results show a medium level of vaccine literacy (M = 2.37, SD = 0.54) and a significant difference between functional and interactive-critical vaccine literacy (p < 0.001). The level of vaccine literacy grew with the level of education (p = 0.031) and reduced with age (p < 0.001). Participants who were employed, had chronic diseases, took medicine, or consumed alcohol daily had a lower level of vaccine literacy. There is room for progress in the COVID-19 VL level for the adult population in Croatia, especially at the interactive-critical VL, which could have an important role in people accepting the vaccine against the COVID-19 disease. A satisfactory level of vaccine literacy in the population is necessary because it can contribute to the fight against the pandemic.

Chronic Stress and Gonadectomy Affect the Expression of Cx37, Cx40 and Cx43 in the Spinal Cord.

The study aimed to determine whether the exposure to chronic stress and/or performance of gonadectomy might lead to disturbance in the expression of connexin (Cx) 37, 40 and 43 in the spinal cord (SC), as a potential explanation for sex differences in stress-related chronic pain conditions. After the rats were sham-operated or gonadectomized, three 10-day sessions of sham or chronic stress were applied. Immunohistochemistry and transmission electron microscopy (TEM) were used to examine Cx localization and expression in the SC. The gonadectomy resulted in an increase of Cx37 expression in the dorsal horn (DH) of the female rats, but chronic stress suppressed the effects of castration. In male rats, only the combined effects of castration and chronic stress increased Cx37 expression. The influence of chronic stress on the DH Cx40 expression was inversely evident after the castration: increased in the ovariectomized female rats, while decreased in the orchidectomized male rats. We did not find any effect of chronic stress and castration, alone or together, on Cx43 expression in the DH, but the percentage of Cx43 overlapping the astrocyte marker glial fibrillary acidic protein (gfap) increased in the male stressed group after the castration. In conclusion, the association of the chronic stress with sex hormone depletion results in disturbances of the SC Cx expression and might be a possible mechanism of disturbed pain perception after chronic stress exposure.