THE RELATIONSHIP BETWEEN PERFECTIONISM AND ANGER IN ADOLESCENTS

Background: As a contribution to the dimensional classification of mental disorders, which in the next edition of the American Psychiatric Association (APA) could dominate over the categorical, and in general, due to the impact of anger on the behavior of individuals in our society, it seems important to examine and analyze dimensions that represent risk factors for occurrence and development of anger disorders. Aim: To examine gender differences in the expression of the adaptive and maladaptive dimensions of perfectionism and anger (state and trait, as well as the anger expression and control) and to examine whether the dimensions of perfectionism are statistically significant predictors of anger. Subjects and methods: This study included a total of 600 primary and secondary school students (305 girls and 295 boys), 12 to 18 years old. Data were collected using a Socio-demographic Features Questionnaire for general information onto the Adaptive/ Maladaptive Perfectionism Scale (AMPS), Child-Adolescent Perfectionism Scale (CAPS), and State-Trait Anger Expression Inventory- 2 Child and Adolescent (STAXI-2 C/A). Results: Statistically significant gender differences were found in the expression of the adaptive and maladaptive dimensions of perfectionism and anger. For aspects of anger, girls have been found to control their anger more often than boys. Multiple regression analysis indicates the important contribution of the dimensions of perfectionism in the explanation of anger in adolescents. Conclusion: Given the results obtained, our research represents a contribution to the definition of a dimensional diagnostic system to prevent comorbidity of mental disorders and provide more clinically relevant information about each individual. The instrument which is used to measure anger in this study (STAXI-2 C/A; Brunner & Spielberger 2009) was for the first time applied in Bosnia and Herzegovina. The results of this research are a contribution to its validation

Risk Factors Associated with Cerebral Palsy in Newborns

The aim of this study was to investigate the risk factors associated with cerebral palsy (CP). For this purpose, a total of 55 newborns were investigated in the case control design study, with a total of 55 additional newborns that were matched to the cases. All patients were recruited in University Clinical Hospital Mostar and other institutions in the region between 1997–2005. The comparison of the Apgar score did not seem to show significant differences between cases and controls (odds ratio [OR]=1.15, 95% confidence intervals [CI] 0.36–3.69). Hypoxia was more common in the CP group (36.3% vs. 5.4% in the control group; p<0.001). Additionally, cases were more frequently exposed to the infections (p<0.001), intracranial hemorrhage (p=0.002), premature delivery, before the 28th gestation week (p=0.027), as well as the premature delivery during the 28–34 gestation week (p=0.001), and 34–38 gestation week (p=0.018). Accordingly, small birth weight was associated with cases more often than controls (p=0.003). Bleeding during pregnancy was also more common in cases than controls (p=0.032), while the breech presentation, emergency cesarean section, hydrocephalus, placenta disorders and pre-eclampsia were not associated with CP. The results suggest that CP cases were more commonly exposed to numerous risks, which all seem to contribute to the increased chances of CP. Traditional indicator, poor Apgar score was not found to be significantly associated with the CP

ANXIETY AND DEPRESSION IN ONCOLOGY PATIENTS IN THE MOSTAR UNIVERSITY CLINICAL HOSPITAL

Cilj: Utvrditi stupanj anksioznosti i depresivnosti u bolesnika hospitaliziranih na odjelu onkologije Sveučilišne kliničke bolnice Mostar te povezanost tog stupnja sa spolom, bračnim statusom, dobi i stupnjem naobrazbe. Ispitanici i metode: U istraživanje je bilo uključeno 160 bolesnika, koji su bili podijeljeni u dvije skupine: ispitnu i kontrolnu. Svakom bolesniku iz ispitne skupine bio je pridružen bolesnik iz kontrolne skupine prema dobi, spolu, stupnju naobrazbe i bračnom statusu. Ispitnu skupinu činilo je 80 bolesnika koji su se liječili na odjelu onkologije Sveučilišne kliničke bolnice Mostar od 1. siječnja 2010. godine do 31. ožujka 2010. godine. Kontrolnu skupinu činilo je 80 bolesnika koji su primljeni u ordinaciju obiteljske medicine Doma zdravlja Mostar od 1. ožujka 2010. godine do 31. ožujka 2010. godine. U istraživanju smo se koristili Beckovom ljestvicom anksioznosti i depresivnosti. Prikupljeni su se podaci testirali odgovarajućim statističkim metodama. Rezultati:Ispitanici hospitalizirani na odjelu onkologije imali su veći stupanj depresivnosti u odnosu prema kontrolnoj skupini (egzaktni test, P<0,001). Nismo pronašli značajnu razliku u stupnju anksioznosti između ispitne i kontrolne skupine (egzaktni test, P=0,143). U onkoloških bolesnika s blagim stupnjem anksioznosti najviše su bili zastupljeni bolesnici stariji od 60 godina, dok je u visokom stupnju anksioznosti najviše bila zastupljena dobna skupina od 25 do 40 godina (egzaktni test, P<0,001) te visoko obrazovani bolesnici (egzaktni test, P=0,024). U istraživanju se pokazalo da su u onkoloških bolesnika mlađe dobne skupine imale viši stupanj depresivnosti (egzaktni test, P<0,001). Usporedbom stupnja anksioznosti s obzirom na dob u kontrolnoj skupini pronašli smo statistički značajnu razliku, i to tako da su najviši stupanj anksioznosti imali ispitanici između 41 i 60 godina (egzaktni test, P<0,001). U kontrolnoj skupini u većem su postotku bile depresivnije žene (egzaktni test, P=0,034) i ispitanici stariji od 60 godina (egzaktni test, P=0,006). Zaključak: Ispitna je skupina pokazala statistički viši stupanj depresivnosti, dok za anksioznost nismo utvrdili statistički značajnu razliku između ispitne i kontrolne skupineObjective: To determine the degree of anxiety and depression in patients hospitalized at the Department of Oncology of the Mostar University Clinical Hospital and the relationship between the degree of anxiety and depression, sex, marital status, age, and education of the patients. Patients and methods: The study included 160 patients who were divided into two groups: a test and a control group. A patient from the test group was assigned a patient from the control group according to his/her age, gender, education level and marital status. The study population consisted of 80 patients who were treated at the Department of Oncology of the Mostar University Clinical Hospital from January 1, 2010 to March 31, 2010. The control group consisted of 80 patients who were admitted via the Family Medicine Office of the Mostar Community Health Center from March 1, 2010 to March 31, 2010. The Beck’s Anxiety and Depression scale was used. The appropriate statistical methods were used to test the collected data. Results: Patients hospitalized at the Department of Oncology had a greater degree of depression than the control group (exact test, P<0.001). A significant difference in the level of anxiety between the test and control groups was not found (exact test, P=0.143). A mild degree of anxiety was found in the cancer patients older than 60 and a high level of anxiety in the group aged 25–40 (exact test, P<0.001) and in highly educated patients (exact test, P=0.024). The research showed that the cancer patients from the younger age group had higher levels of depression (exact test, P<0.001). By comparing the degree of anxiety to the age in the control group, statistically significant difference was not found, so the highest level of anxiety was found in the patients aged between 41 and 60 (exact test, P<0.001). It was determined that a higher percentage of women (exact test, P=0.034) and patients over 60 years old (exact test, P=0.006) in the control group were more depressed. Conclusion: Although a statistically higher level of depression was determined for the test group patients, a statistically significant difference in the levels of anxiety between test and control groups was not found

DIFFERENCE IN THE PREVALENCE OF BURNOUT SYNDROME IN PRECLINICAL AND CLINICAL TEACHING DOCTORS OF MOSTAR SCHOOL OF MEDICINE

Cilj rada: Cilj ovoga rada bio je utvrditi razlike u učestalosti pojavnosti sindroma izgaranja u nastavnika pretkliničara i kliničara Medicinskog fakulteta u Mostaru u akademskoj godini 2011./2012. Pozornost je također bila usmjerena na uočavanje razlika u učestalosti pojavljivanja sindroma ovisno o spolu i godinama radnog staža. Hipoteza rada bila je da je vjerojatnost učestalosti sindroma izgaranja veća u nastavnika kliničara ženskog spola s dugogodišnjim radnim stažem. Ispitanici i postupci: U istraživanje su bila uključena 62 ispitanika, nastavnika s visokom akademskom naobrazbom, zaposlena na Medicinskom fakultetu u Mostaru. Razdoblje anketiranja bilo je tri nasumično izabrana susjedna mjeseca u akademskoj godini 2011./12. Podaci su prospektivno prikupljeni anketiranjem uz pomoć standardiziranog upitnika. Istraživani parametri bili su spol, godine radnog iskustva i rad u pretkliničkoj ili kliničkoj nastavi na Medicinskom fakultetu. Rezultati: Istraživanje je pokazalo da između 62 ispitanika 43 od njih (69,4%) nisu imala simptome sindroma izgaranja, dok je u 19 ispitanika (30,6%) zabilježen sindrom u umjerenu stupnju. Nijedan ispitanik nije imao teške simptome navedenog sindroma. Razlika u distribuciji ispitanika prema tome jesu li ili nisu imali sindrom izgaranja nije bila statistički značajna (c2-test=9,29; df=1; P=0,002). Ni s obzirom na spol ispitanika nije utvrđena statistički značajna razlika u intenzitetu sindroma izgaranja između muškog i ženskog spola (c2-test=0,587; df=1;P=0,444). Distribucija učestalosti sindroma izgaranja nije se statistički značajno razlikovala između skupina ispitanika sastavljenih prema dužini radnog staža (c2-test=4,339; df=3; P=0,271). Sindrom je zabilježen u 13 (21%) nastavnika kliničara i 6 (9,7%) pretkliničara. Razlika u učestalosti intenziteta izgaranja među navedenim skupinama nije bila statistički značajna (c2-test=3,718; df=1; P=0,054). Zaključak: Rezultatima ovog istraživanja nije dokazano da se sindrom izgaranja javlja učestalije u ispitanika uključenih u klinički dio nastave nego u onih na pretkliničkoj nastavi. Nije uočena ni razlika u učestalosti sindroma s obzirom na spol i godine radnog staža.Aim: The aim of this study was to determine the difference in the prevalence of burnout syndrome in preclinical and clinical teaching doctors of Mostar School of Medicine in the academic year 2011/2012. Special attention was also focused on finding out the possible difference between the syndrome incidence that was correlated to gender and years of service. The main hypothesis was that the probability of burnout syndrome incidence was higher in the group of female clinical teaching doctors having more years of service. Subjects and methods: The study involved 62 people with high academic education employed at Mostar School of Medicine who were surveyed during a randomly selected consecutive 3-month period (February to May) of the academic year 2011/2012. The data were prospectively collected through a standardized questionnaire survey. The studied parameters were gender, years of work experience and the engagement in preclinical or clinical departments of the Medical School. Results: The survey showed that 43 out of 62 (69.4%) respondents did not suffer the burnout syndrome, while moderate syndrome was recodred in 19 (30.6%) of them. No person had serious symptoms of the syndrome. The difference between the respondents who suffered the syndrome and those who did not was not statistically significant (P=0.002). Considering the gender of respondents, statistically significant differences were not confirmed (P=0.444). Considering the years of service, the highest incidence of the syndrome was found in people with more work experience (in the group of 21–25 years), but the difference between the groups was not statistically significant (P=0.271). Observing the work in preclinical and clinical departments, because of the limited number of patients we could not confirm the hypothesis. The syndrome had affected 13 (21%) clinical teaching doctors and 6 (9,7%) preclinical doctors, while the differenece between them was not statistically significant (P=0.054). Conclusion: Considering the results of this research, it has not been proven that the burnout syndrome occurred more frequently in doctors who were involved in clinical teaching than in doctors who tought in preclinical departments. Also, there was no difference in the appearance of the syndrome that was related to gender and years of service

THE FREQUENCY OF BURNOUT SYNDROME IN PHYSICIANS IN MOSTAR UNIVERSITY HOSPITAL

Cilj: Utvrditi učestalost sindroma burnout u kliničkih liječnika SKB-a Mostar. Ispitanici i postupci: U istraživanje su uključena 94 ispitanika od 131 liječnika koji su radili u ustanovama obuhvaćenim istraživanjem. Oni su bili upoznati sa svrhom istraživanja te su svrstani u tri skupine specijalizacija. Prvu skupinu činili su liječnici Klinike za unutarnje bolesti i Odjela za dječje bolesti, drugu skupinu činili su liječnici Odjela za kirurgiju i Odjela za ginekologiju i porodništvo, dok su treću skupinu (CL-specijalizacije) činili liječnici Klinike za kožne i spolne bolesti, Odjela za otorinolaringologiju i Odjela za oftalmologiju. Svim ispitanicima podijeljen je anonimni upitnik za procjenu izgaranja na poslu. Upitnik se sastojao od 18 tvrdnji uz koje se nalaze brojevi od 1 do 3 od kojih 1 znači rijetko, 2 često, 3 uvijek, a zadatak ispitanika bio je zaokružiti odgovarajući broj ovisno o tome koliko ih određena tvrdnja opisuje. Uz ove tvrdnje upitnik je sadržavao podatke o mjestu zapošljavanja, godinama radnog iskustva i spolu. Rezultati: U istraživanom uzorku ispitanici najučestalije (n = 81; 86,2%) nisu imali simptome sindroma izgaranja. Što se tiče osoba koje su imale navedene simptome svi su pripadali umjerenom intenzitetu (c2-test = 49,19; s.s. = 1; P < 0,001). Teške simptome navedenog sindroma nije imao nijedan ispitanik. Intenzitet simptoma izgaranja ispitanika nije bio značajno različit između muškog i ženskog spola (c2-test = 0,85; s.s. = 1; P = 0,355) niti se statistički značajno razlikovao ovisno o broju godina radnog staža (egzaktni test; P = 0,888). Nakon formiranja triju skupina iz sedam Klinika uključenih u istraživanje prema dosad percipiranom intenzitetu stresnih situacija nije se pokazala značajna razlika u intenzitetu simptoma izgaranja između novoformiranih skupina klinika (egzaktni test; P = 0,536). Promatrajući individualno čestice upitnika u cjelokupnom uzorku, u 5 čestica postojao je češće zaokružen visoki intenzitet simptoma izgaranja, s tim da je najučestalije prijavljen visok intenzitet simptoma bio osjećaj nemoći za promjenu nečega u poslu (c2-test = 78,04; s.s. = 14; P < 0,001). Zaključak: Najveći broj ispitanika nema simptome sindroma burnout, a oni koji ih imaju nalaze se u umjerenoj fazi izgaranja. Nema statistički značajne razlike u učestalosti sindroma burnoutizmeđu novoformiranih skupina specijalizacija.Aim: To determine the prevalence of burnout syndrome in clinical physicians in Mostar University Hospital. Subjects and methods: The study included 94 subjects who were familiar with the purpose of research and were classified into three specialty groups. The first consisted of doctors in the Department of Internal Medicine and Department of Pediatrics, the second group of doctors in the Department of Surgery and Department of Gynecology and Obstetrics, while the third group (CL-specialization) were doctors of the Clinic of Dermatology and Venereal Diseases, Department of Otorhinolaryngology and Department of Ophthalmology. All subjects were handed anonymous questionnaire to assess burnout. The questionnaire consisted of 18 statements with numbers from 1 to 3, 1 meaning rarely, 2 often and 3 always The task was to circle an appropriate number depending on how the statement described them. Along with these statements the questionnaire contained information on the place of employment, years of work experience and gender. Results:In the studied sample of respondents most (n = 81, 86.2%) didn’t have symptoms of burnout syndrome. As for the people who had these symptoms, they all belonged to the moderate intensity (c2 test = 49.19, df = 1, P<0.001), while none had severe symptoms of this syndrome. The intensity of the symptoms in the subjects was not significantly different between males and females (c2 test = 0.85, df = 1, P = 0.355). Also, the intensity of symptoms in the subjects did not differ significantly depending on the number of working years (exact test, P = 0.888). After the formation of three groups from seven departments involved in the research of so far perceived intensity of stress, no significant differences in the intensity of the symptoms of burnout were found between them (exact test, P = 0.536). Regarding the individual items in the overall survey sample, in five items high intensity symptoms of burnout were most often circled. The most frequently reported high intensity of the symptoms was the sense of inability to change something at work (c2 test = 78.04, df = 14, P<0.001). Conclusion: The majority of respondents did not have symptoms of burnout syndrome, and those who had them were in the moderate stage of burnout. No statistically significant differences in the incidence of burnout syndrome between the groups of specialties were found

Stajališta i navike adolescenata prema oralnome zdravlju u Hercegovini

The aim of the study was to determine attitudes towards and habits in oral health of adolescents in Herzegovina, as well as to evaluate the possible differences in habits among individuals of different adolescent categories. The study included 120 participants (35 male and 85 female) divided into three adolescent categories, as follows: early (11-14 years of age), middle (15-18 years) and late (19-21 years) adolescence, from the Herzegovina-Neretva Canton, who presented for dental examination. All participants completed the socio-demographic questionnaire and standardized Hiroshima University Dental Behavioral Inventory (HU-DBI). The answers provided by study adolescents in the HU-DBI showed statistically significant differences among particular age groups, i.e. between early and middle adolescence in items 7 (p=0.046) and 15 (p=0.007); between middle and late adolescence in items 8 (p=0.021), 11 (p=0.04) and 12 (p=0.027); and between middle and late adolescence in item 11 (p=0.032). Respondents in middle adolescence had poorer oral hygiene attitudes than those in early and late adolescence. In order to improve the oral hygiene habits of adolescents in Herzegovina, it is necessary to put emphasis on continuous education about oral hygiene habits during their secondary education.Cilj ovoga istraživanja bio je utvrditi stajališta i navike adolescenata prema oralnome zdravlju u Hercegovini, kao i procijeniti moguće razlike u navikama između ispitanika različitih adolescentskih kategorija. U istraživanje je bilo uključeno 120 ispitanika (35 muških, 85 ženskih) podijeljenih u tri adolescentske kategorije: ranu (11-14 godina), srednju (15-18 godina) i kasnu (19-21 godina) adolescentsku dob s područja Hercegovačko-neretvanske županije, koji su došli na dentalni pregled. Svi ispitanici ispunili su Sociodemografski upitnik i standardizirani Hiroshima University-Dental Behavioral Inventory (HU-DBI). U odgovorima iz upitnika HU-DBI utvrđene su statistički značajne razlike s obzirom na dobne skupine adolescenata: između rane i srednje adolescentske dobi u 7. (p=0,046) i 15. (p=0,007) pitanju, između srednje i kasne adolescencije u 8. (p=0,021), 11. (p=0,04) i 12. (p=0,027) pitanju te između srednje i kasne adolescencije u 11. (p=0,032) pitanju. Ispitanici u srednjoj adolescenciji imali su lošije oralno-higijenske stavove od ispitanika u ranoj i kasnoj adolescenciji. Provedba obrazovnih programa o promicanju oralnog zdravlja tijekom srednjoškolskog obrazovanja potrebna je radi unaprjeđenja oralnohigijenskih navika kod adolescenata u Hercegovini

PREVALENCE OF INTELLECTUAL DISABILITIES AND EPILEPSY IN DIFFERENT FORMS OF SPASTIC CEREBRAL PALSY IN ADULTS

Background: Spastic cerebral palsy may be interconnected with other neurodevelopmental disorders such as intellectual disabilities, and epilepsy. Brain synaptic plasticity and successful restorative rehabilitation may also contribute to diminish neurological deficit of patients having cerebral palsy. The aim of this study was to investigate the prevalence of intellectual disabilities and epilepsy in adult patients with different forms of spastic cerebral palsy and to find out correlation between the severity level of intellectual disabilities and epilepsy. Subjects and methods: Adults diagnosed with different forms of spastic cerebral palsy were analyzed during a three-month period. The investigated features were: gender and age; form of cerebral palsy; the prevalence of intellectual disabilities and epilepsy. Intellectual disabilities were divided into 4 severity levels. The correlation between the severity level of intellectual disabilities and epilepsy was statistically analyzed. Results: Intellectual disability was present in 55% of patients diagnosed with spastic cerebral palsy. Epilepsy was present in 36% of such patients. It was recorded in 51.1% of quadriplegic, 21.9% of diplegic, and 19.2% of hemiplegic patients. Intellectual disability was present in 73.8% of quadriplegic, 31.3% of diplegic, and 53.8% of hemiplegic patients. The statistically significant correlation existed between the severe intellectual disability and epilepsy. Conclusions: Intellectual disabilities and epilepsy most frequently occurred in patients with most severe forms of spastic cerebral palsy. Epilepsy is strongly correlated to the severity level of intellectual disability. Such patients require additional special modes of treatment and restorative rehabilitation to improve the functional outcome

Prognostic value of lactates in relation to gas analysis and acid-base status in patients with pulmonary embolism

Aim To assess the prognostic value of lactate level for mortality in patients with pulmonary embolism (PE) and Pulmonary Embolism Severity Index (PESI) I-III and its independence of gas-analysis parameters and acid-base status. Methods This prospective observational study was conducted at the University Clinical Hospital Mostar from 2013 to 2017. On the first day after PE diagnosis, 1.5 mL of arterial blood was collected from 103 patients with PE. Partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide in arterial blood, blood pH value, concentration of bicarbonates in arterial blood (HCO3-), base deficit, and oxygen saturation were analyzed. Lactate levels were assessed using blood samples taken from the cubital vein. Logistic regression analysis was used to assess the predictive value of gas-analysis variables, lactate level, PESI score, age, and sex for in-hospital death due to PE. Results The mortality in the group of PE patients was 19.1% (18 of 103 patients). Lactate level was an independent predictor of mortality (P = 0.002, odds ratio 0.06). HCO3- was also found to be a significant predictor (P = 0.022, odds ratio 2.4). Lactates were independent of other variables. Other gas-analysis parameters were not significant predictors of mortality. Conclusion In PE patients at low-intermediate risk of mortality (PESI I-III), lactate level was associated with a shortterm mortality, independently of other gas-analytic parameters