The Influence of Sociodemographic Factors on the Level of Hope in Women with Breast Cancer

Background

We aimed to determine the level of hope in breast cancer patients along with the influence of sociodemographic characteristics on the expressed level of hope.

Methods

A descriptive cross-sectional study was conducted on the sample size of 72 female patients with breast cancer diagnosis. The study was conducted at the University Clinical Center of Kragujevac, Serbia from November 2020 until March 2022. Data were collected from the patients in a form of the Sociodemographic Variables Questionnaire (Q-SV). The Herth Hope Index (HHI) was used in assessing the level of hope.

Results

The value of the total HHI score was ranging from 14 to 48, whereas the mean value of the HHI score was 40.00±5.92. The significantly higher level of hope was reported in female patients who: searched the Internet for gathering information on their disease (39.24±6.23; P=0.047), were religious (38.77±6.13; P=0.003), believed in God (38.45±5.51; P=0.004), had no formal medical education (38.44±5.75; P=0.036) and after therapy (38.76±6.49; P=0.022).

Conclusion

Hope is an existential internal resource possibly affecting the manner in which female patients perceive their own health state and future as well. A better understanding of the meaning of hope during treatment can be of great value in supporting cancer patients.

Neuroimmune, clinical and treatment challenges in multiple sclerosis-related psychoses

In recent years, epidemiological and genetic studies have shown an association between autoimmune diseases and psychosis. The question arises whether patients with schizophrenia are more likely to develop multiple sclerosis (MS) later in life. It is well known that the immune system plays an important role in the etiopathogenesis of both disorders. Immune disturbances may be similar or very different in terms of different types of immune responses, disturbed myelination, and/or immunogenetic predispositions. A psychotic symptom may be a consequence of the MS diagnosis itself or a separate entity. In this review article, we discussed the timing of onset of psychotic symptoms and MS and whether the use of corticosteroids as therapy for acute relapses in MS is unfairly neglected in patients with psychiatric comorbidities. In addition, we discussed that the anti-inflammatory potential of antipsychotics could be useful and should be considered, especially in the treatment of psychosis that coexists with MS. Autoimmune disorders could precipitate psychotic symptoms, and in this context, autoimmune psychosis must be considered as a persistent symptomatology that requires continuous and specific treatment.

Transcultural adaptation and validation of the Serbian version of the colorectal-specific quality of life questionnaire FACT-C

Objective

Transcultural adaptation and validation of the FACT-C questionnaire to Serbian language.

Methods

The study included 131 patients with colorectal cancer. Translation included standard forward and backward translation from original language to Serbian and back. Pilot testing of the questionnaire was conducted on 10 patients with diagnosed colorectal cancer. The questionnaires EORTC-QLQ-C30 and DASS will be used as validated tools to evaluate validity of examined, FACT-C questionnaire.

Results

The FACT-C demonstrated satisfactory construct validity using Cronbach’s alpha. Satisfactory concurrent validity was demonstrated using correlations with EORTC-QLQ-C30 and DASS questionnaires. High reproducibility was demonstrated using repeated questionnaires on 30 patients two weeks after the first interview.

Conclusion

The Serbian version of the FACT-C was demonstrated to have satisfactory applicability, reliability and validity in Serbian patients with colorectal cancer. It can be considered as a valid colorectal cancer specific health related quality of life tool for the Serbian population.

Mental Health Assessment of Cancer Patients: Prevalence and Predictive Factors of Depression and Anxiety

Background:

Patients with oncological diseases often have mental disorders in the form of comorbidity. The aim of this study was to research the association of cancer with the presence of symptoms of depression and anxiety in primary health care patients.

Methods:

This prospective observational study done in 2020 included adult users of health care at the Health Center Trstenik, Central Serbia, aged 19 and over, both sexes, with a diagnosis of oncological disease. A research instrument to assess depressive symptoms is used PHQ-9 (The Patient Health Questionnaire) questionnaire, derived from PRIME MD- and (The Primary Care Evaluation of Mental Disorders), and the Beck Anxiety Scale (BAI) to register the presence of certain anxiety symptoms.

Results:

The largest percentage of patients had symptoms of mild (27.2%) or moderate depression (22%), while 18% reported symptoms of major depression. The level of depression was higher in older subjects, in the presence of chronic diseases with greater limitations of activity and the presence of difficulties in performing daily activities, with a more pronounced effect of pain on activity, the presence of stress. All subjects were characterized as persons with severe anxiety (score 26–63). The level of anxiety was higher in older respondents, in the presence of long-term illness, with greater limitations of activities and difficulties in performing daily activities, with a more pronounced influence of pain on performing activities and the influence of the media.

Conclusion:

Caring for the mental health of cancer patients must occupy a significant part of each country’s national health policy.

Knowledge and attitudes on medical waste management among Belgrade medical and dental students

Introduction/Objective. Knowledge and practical skills in medical waste (MW) management are of equal importance for medical and dental doctors. The first comparative study on the knowledge and skills in the field of MW management among Belgrade students was conducted with the goal of examining whether students of medicine and dentistry are equally familiar with this extremely important field. Methods. A cross-sectional study included 558 students of the sixth year of studies (430 medical and 128 dental students) who completed an anonymous semi-structured questionnaire to determine attitudes and knowledge on MW management. Results. The majority of medical and dental students had no training in MW management (79.5% and 74.6%, respectively). Dental students use protective equipment more frequently than medical students (94.5% vs. 42%, p < 0.001). However, full vaccinal protection against hepatitis B is better among medical students compared to dental students (57.7% vs. 39.1%, p < 0.001). Complete knowledge on postexposal prophylaxis is better among medical students compared to dental students (44.5% vs. 13.3%, p < 0.001). However, dental students are more disciplined in reporting injuries (63.1% vs. 52.4%, p = 0.038). The students? knowledge on primary separation of infectious waste (93% vs. 77.8%, p < 0.001) and used needles (80.3% vs. 70.4%, p = 0.007) is better among dental students compared to medical students? correct answers. Conclusion. Dental students show better knowledge on MW management and are more disciplined in using personal infection protection compared to medical students. The students support continued training on MW management and investigations on this topic.

Applying the Molecular Adsorbent Recirculating System (MARS) in the Treatment of Acute Liver Failure (ALF) Case Report

Acute liver failure (ALF) is a rare but life-threatening illness with multiple organ failure. The short-term mortality rate exceeded 80 % despite modern approaches in treatment. Drugs, infections by hepatic viruses and toxins are the most common causes of ALF. Progressive jaundice, coagulation disorder and hepatic encephalopathy are dominated as a clinical signs of the illness. We present a case of a 36-year-old Caucasian woman hospitalized in ICU due to yellow discoloration of the skin and sclera, severe disseminated coagulopathy and hemodynamic instability. ALF is developed due to Hepatitis B Virus infection, resulting in hepatic toxicity as well as coma. General condition rapidly improved after applying of Molecular Adsorbent Recirculating System (MARS), an extracorporeal liver support system based on albumin dialysis. It is relatively expensive treatment that is used for the patient with hepatic encephalopathy grade 3 or 4 in our institution. In conclusion, an early administration of MARS significantly reveals subjective and objective clinical improvement in the case we presented.

Specific Polymorphism 4G/5G Gene for PAI-1 as a Possible Cause of Cerebral Venous Thrombosis: A Case Report

Thrombosis of veins and venous sinus (CVT) is the rare cerebral vascular disorder which makes less than 1% of all strokes. Thrombosis of veins and venous sinuses is picturesquely called “мајоr neurological forger” since it is characterized by very varied clinical picture. Among the various causes of CVT, which can be of infective or non-infective nature, the congenital hyper coagulations especially stand out, diagnosis is based on highly sophisticated diagnostic tests.

We present the case of a female patient, 36 years old, who was hospitalized at the Clinic for Neurology in Clinical Center because of the diffuse headache she had for the last few days, with milder right-sided hemiparesis and one generalized tonic-clonic epileptic seizure. With nuclear magnetic resonance (MR/2D venography) the thrombosis of the upper and lower sagittal sinuses is confirmed. By appropriate laboratory tests, as well as by confirmatory immunological and genetic analyses, the impact of the most of the factors is excluded which can contribute to the occurrence of venous thrombosis. The only pathological findings which indicated the possible congenital thrombophilia as the cause of the sagittal sinus thrombosis was the determination of the specific polymorphism of the 4G/5G gene for plasminogen activator inhibitor 1.

According to our knowledge, this is the first decribed case of the possible impact of the specific polymorphism of the 4G/5G gene for plasminogen activator inhibitor of 1 on the development of cerebral venous thrombosis.

EEG Abnormalities as Diagnostic and Prognostic Factor for Encephalitis

The aim of the study is to examine whether EEG abnormalities in patients with encephalitis might be prognostic and diagnostic factors for final epilepsy outcome and/or be correlated with the severity of the disability.

The most frequent causes of encephalitis were HSV, WNV, INF V, MTB, St PN, St AU. There was a highly statistically significant positive correlation between the severity of the EEG abnormalities at the beginning of the disease (r = 0.410, p <0.01) and the ultimate outcome.

Electroencephalography in the early stages of encephalitis shows diagnostic and prognostic significance and, in combination with the overall severity of the clinical picture, could contribute to the diagnosis and assessment of outcomes and, ultimately, the correction of treatment and faster recovery of patients. This is particularly true for viral encephalitis.