Healthy and controlled immune response in COVID-19 is crucial for mild forms of the disease. Although CD8+ T cells play important role in this response, there is still a lack of studies showing the gene expression profiles in those cells at the beginning of the disease as potential predictors of more severe forms after the first week. We investigated a proportion of different subpopulations of CD8+ T cells and their gene expression patterns for cytotoxic proteins (perforin-1 (PRF1), granulysin (GNLY), granzyme B (GZMB), granzyme A (GZMA), granzyme K (GZMK)), cytokine interferon-γ (IFN-γ), and apoptotic protein Fas ligand (FASL) in CD8+ T cells from peripheral blood in first weeks of SARS-CoV-2 infection. Sixteen COVID-19 patients and nine healthy controls were included. The absolute counts of total lymphocytes (p = 0.007), CD3+ (p = 0.05), and CD8+ T cells (p = 0.01) in COVID-19 patients were significantly decreased compared to healthy controls. In COVID-19 patients in CD8+ T cell compartment, we observed lower frequency effector memory 1 (EM1) (p = 0.06) and effector memory 4 (EM4) (p < 0.001) CD8+ T cells. Higher mRNA expression of PRF1 (p = 0.05) and lower mRNA expression of FASL (p = 0.05) at the fifth day of the disease were found in COVID-19 patients compared to healthy controls. mRNA expression of PRF1 (p < 0.001) and IFN-γ (p < 0.001) was significantly downregulated in the first week of disease in COVID-19 patients who progressed to moderate and severe forms after the first week, compared to patients with mild symptoms during the entire disease course. GZMK (p < 0.01) and FASL (p < 0.01) mRNA expression was downregulated in all COVID-19 patients compared to healthy controls. Our results can lead to a better understanding of the inappropriate immune response of CD8+ T cells in SARS-CoV2 with the faster progression of the disease.

Background: Painful and damaged nipples are frequently associated with breastfeeding cessation in the early postpartum period. The results of researchers’ studies utilizing different treatments have been inconclusive. Research Aim: To compare the intensity of nipple pain and the healing of damaged nipples during the first 10 days postpartum using either lanolin or human milk treatments. Methods: This single-blind randomized controlled trial included participants ( N = 206) who were primiparous with painful and damaged nipples. Participants were recruited from the tertiary teaching hospital within the first 72 hr after delivery and randomized to the intervention group with lanolin ( n = 103) and a human milk control group ( n = 103). Data were collected in the maternity ward, 3 and 7 days after randomization. The primary outcome was nipple pain intensity and quality measured 3 and 7 days after randomization by the McGill Pain Questionnaire – short form. The nipple damage self-assessment questionnaire was used for the assessment of nipple healing. Breastfeeding self-efficacy, breastfeeding duration, and exclusivity were assessed as secondary outcomes. Results: Participants in both groups reported a statistically nonsignificant reduction in pain (quality and intensity of pain) as well as improved nipple healing 7 days after randomization. Participants in the lanolin group exclusively breastfed their infants 3 days after randomization—significantly more often than participants in the control group ( p = .026). The study did not reveal any statistically significant differences for other secondary outcomes. Conclusion: Both lanolin and human milk are equally effective in treating painful and damaged nipples. Registered with Clinicaltrials.gov (NCT04153513)

Aim To examine whether there are differences in the experience in giving informed consent of patients whose surgery was elective compared to emergency surgery in the same department. Methods A prospective cross-sectional study was conducted in the Department of Gynaecology and Obstetrics of University Clinical Hospital Mostar during a 6-month period. The sample of respondents consisted of two groups of patients, 145 with elective surgery and 90 patients with emergency surgery. The study was conducted using an anonymous questionnaire. Results Patients in both examined groups were equally satisfied with the procedure of informed consent. Most patients signed the informed consent at the request of a nurse, 195 (83%). During the process of consenting, almost all patients, regardless of whether they had elective or emergency surgery, claimed that they understood the form, which had to be signed, it was important to them, 230 (97.9%), except the patients who had elective surgery, 130 (90.3%), regularly stated that having an opportunity to ask questions was important to them. Respondents with emergency surgery more frequently agreed to sign whatever was in the form, 42 (46.7%). Conclusion Patients who had a planned surgery and patients who had an urgent surgery, mostly declare contentment with the use of informed consent although they did not have the same experience about informed consent.

The prevalence of gestational diabetes mellitus (GDM), as a complex problem in pregnancy, is increasing all over the world, but most noticeable in developing countries. To estimate GDM prevalence and associated pregnancy features in the southern part of Bosnia and Herzegovina. A cross-sectional observational study was conducted from October 2010 through March 2011. A total of 285 pregnant women with singleton pregnancies participated and were asigned to the study in the order they came for their usual ante-natal clinic examination. They underwent an oral glucose tolerance test (OGTT) with 75 g of glucose. Information on OGTT results, maternal characteristics and pregnancy outcomes were collected from database and medical records. Prevalence of GDM was 10.9% according to 1999 World Health Organisation (WHO) diagnostic criteria. Prenatal cigarette smoking, previous GDM, cesarean delivery rate and neonatal hypoglycemia were significantly more frequent in the GDM group compared to the group of pregnancies with normal glucose tolerance (p = 0.015, p < 0.001, p = 0.015, p = 0.002). This study presents a relatively high prevalence of GDM in Bosnia and Herzegovina. There is a need for large well-designed study on GDM prevalence and its other features.

Uvod: Antenatalna depresija je oblik kliničke depresije koji može imati razoran utjecaj na ženu tijekom trudnoće i može prethoditi postporođajnoj depresiji ako se ne liječi na vrijeme i pravilno. Činjenica je da se antenatalna depresija nedovoljno dijagnosticira, i kao posljedica toga, nedovoljno liječi. Rizik se povećava kako se trudnoća razvija, te se procjenjuje da će 18% trudnica razviti antenatalnu depresiju. Depresivni poremećaji tijekom trudnoće mogu štetno utjecati na tijek trudnoće, njezin ishod i započinjanje dojenja. Cilj: Svrha ovog rada je ukazati na povezanost depresivnih poremećaja tijekom trudnoće s nepovoljnim ishodima trudnoće, poroda i započinjanja dojenja, te ukazati na važnost boljeg probira na depresiju u trudnoći kao dijela rutinske prenatalne skrbi. Razrada: Neliječena antenatalna depresija može imati značajne posljedice i za majku i za njezino dijete. Visoke razine simptoma depresije u trudnica povezane s nepovoljnim opstetričkim i neonatalnim ishodima, uključujući povećani rizik za spontani prijevremeni porod, nisku porođajnu težinu, preeklampsiju, dijabetes, itd. Trudnice s simptomima depresije većinom ne namjeravaju dojiti i znatno manje započinju dojenje u prvom satu nakon poroda. Važnu ulogu u otkrivanju depresije u trudnoći imaju programi probira koji moraju biti dio preventivne zdravstvene zaštite trudnica, te ih treba jasno nadopunjavati smjernicama i protokolima za daljnji tretman trudnica kojima je potrebna pomoć. Zaključak: Neophodna je edukacija iz područja depresije u trudnoći svih zdravstvenih djelatnika uključenih u liječenje trudnica, uključujući i primalje, jer se time povećavaju izgledi za prevenciju depresije, brža dijagnoza, liječenje i smanjenje opasnosti od nepovoljnih ishoda poroda i dojenja.