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Copyright of Contributions of Macedonian Academy of Sciences & Arts is the property of Macedonian Academy of Sciences & Arts (MANU) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Contributions of Macedonian Academy of Sciences & Arts is the property of Macedonian Academy of Sciences & Arts (MANU) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: This study sought to provide updated estimates of the occurrence of intimate partner violence (IPV) in the general adult population of Ireland and to better understand gender-specific profiles of IPV, their risk factors, and their relationship with suicidality., Method: Data ( N = 1,098) from Wave 4 of the Irish arm of the COVID-19 Psychological Research Consortium (C19PRC) study were used., Results: 32.1% of the sample experienced lifetime IPV, with IPV more common among females. Latent class analysis results showed that females had a more complex profile of IPV (four classes) than males (three classes). Risk factors for females included younger age, having children, lower income level, lower social support, and lower social contact, while risk factors for males were living in an urban environment, having children, and lower social support. All IPV exposure was found to be associated with a significantly higher likelihood of experiencing multiple suicide-related phenomena for males and females., Conclusion: IPV is a major public social health issue affecting approximately one-in-three females and one-in-four males in Ireland and is strongly associated with suicide-related phenomena. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The COVID-19 pandemic significantly affected family life, increasing parental stress around health, job losses, reduced salaries, and maintaining domestic life in lockdown and social isolation. The transition to home-schooling and remote work with school and workplace closures caused additional stressors as families began living, working, and educating in one place. This research aims to understand the relationship between the pandemic and parental stress, focusing on family well-being and established characteristics of the family unit that may cause some family members to experience the adverse consequences of the pandemic in more or less profound ways, especially mothers. Previous research shows that mothers carry more family responsibilities than fathers and can experience higher stress levels. This study employed a quantitative cross-sectional online survey to extend our understanding of the interaction between home-schooling, work and home life, and stress levels in a group of 364 parents. In total, 232 mothers and 132 fathers completed the survey. Results revealed mothers were 10 times more likely to be responsible for home-schooling than fathers, and 44% of mothers felt they had no help with home-schooling and were generally more stressed than fathers. These results show that lack of support, managing home-schooling, and being a mother predicted increased stress. 10% of mothers reported leaving their jobs due to pressure added by home-schooling. This study broadens the understanding of the pandemic's impact on gender imbalances in family responsibilities. It emphasises the need for extra consideration for the impact on mothers as we emerge from this pandemic., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 O’Sullivan, Rock, Burke, Boyle, Joksimovic, Foley and Clark.)

Mitigating the adverse physical health risks associated with COVID-19 has been a priority of public health incentives. Less attention has been placed on understanding the psychological factors related to the global pandemic, especially among vulnerable populations. This qualitative study sought to understand the experiences of children and adolescents during COVID-19. This study interviewed 48 families during the COVID-19 pandemic restrictions, and a national lockdown, to understand its impacts. The study used an Interpretative Phenomenological Analysis (IPA) methodology. Parents and children discussed the negative impact of the restrictions on young people's wellbeing. Children and adolescents experienced adverse mental health effects, including feelings of social isolation, depression, anxiety, and increases in maladaptive behaviour. Families with children with Autism Spectrum Disorders reported increased mental health difficulties during this period mostly due to changes to routine. The findings highlight the impact of severe restrictions on vulnerable populations' wellbeing and mental health outcomes, including children, adolescents, and those with Autism spectrum disorder (ASD).

Background: Chronic hepatitis C virus infection represents a more frequent cause of liver cirrhosis and hepatocellular carcinoma. Statins, inhibit HCV replication in vitro, enhance the antiviral effect of the already known antiviral drugs and reduce their resistance., Aim: To determine the impact of additional therapy (treatment with Atorvastatin 20 mg) to the standard antiviral therapy (pegylated interferon alpha-peg-IFN α and ribavirin) on achieving sustained virological response (SVR)., Material and Methods: In the study which is comparative, open-label, prospective-retrospective, 70 patients diagnosed with chronic hepatitis C virus infection who met criteria for treatment with standard antiviral therapy combined with anti-lipemic therapy (Atorvastatin 20 mg) were included. Patients in the study were divided into two groups: one group of 35 patients receiving combination therapy (Atorvastatin + peg-IFN α + Ribavirin) and another group of 35 patients received only standard antiviral therapy. Those parameters were followed in all patients: genotyping, quantification of the virus, histological assessment of liver inflammation and fibrosis degree (before starting treatment), the presence of steatosis, laboratory analysis: hematology, liver, lipid and carbohydrate status, insulin blood level (the calculation of HOMA-IR) and body mass index (BMI) calculation. The overall treatment of the patients depends from the virus genotype, thus, patients with genotype 1 and 4 received 48 weeks standard antiviral therapy, but patients with genotypes 2 and 3 received 24 weeks of antiviral therapy. SVR was considered an undetectable level of HCV RNA levels 24 weeks after completion of antiviral therapy. The results were statistically analysed, and all results for p < 0.05 were considered statistically significant., Results: Combination therapy leads to a slightly higher percentage of SVR (85.71%) in patients with chronic hepatitis C versus standard therapy (74.29%), but in a group of patients with genotype 3 this rate of SVR amounting to 95.83%. Combination therapy leads to significant improvement of lipid and glucose status after treatment, and in terms of side effects, there was no appearance of serious adverse events that would be a reason for discontinuation of the therapy., Conclusion: Combination therapy Atorvastatin + pegylated interferon alpha + Ribavirin leads to high rate of SVR of 95.83% in patients with chronic hepatitis C, genotype 3. Statins can be used safely in patients with chronic hepatitis C.

Introduction: The success of the antiviral treatment in patients with chronic hepatitis C depends on the factors related to the virus and the host. The aim of the study is the analysis of the antiviral therapy which is a combination of pegylated interferon and ribavirin, considering various factors that will identify the predictors of the sustained virological response., Material and Methods: This retrospective study included 226 patients, divided in two groups. Patients with sustained virological response and patients without sustained virological response were compared in terms of the following factors: genotype, viral load, gender, age, inflammatory and fibrotic changes in the liver, metabolic abnormalities, obesity and fatty liver., Results: The rate of the sustained virological response is 83.6%, more frequently in patients with genotype 3, with evidenced statistical significance (90.54%). The factors that significantly contribute to sustained virological response are related to the age (p = 0.0001), genotype (p = 0.002), mode of transmission (p = 0.005), inflammatory changes in the liver (p = 0.028), body mass index (p = 0.022) and insulin resistance (p = 0.039). The high rate of sustained virological response is related to the younger age of the patients which indirectly means short Hepatitis C Virus infection duration, absence of advanced liver disease and lack of significant co-morbid conditions. Single confirmed independent predictors of sustained virological response are the age (OR 0.928, p = 0.0001) and genotype (OR 3.134, p = 0.005)., Conclusions: Factors that are related to the virological response are the age, genotype, mode of transmission, inflammatory changes in the liver, body mass index and insulin resistance, but still, independent predictors of sustained virologic response are the age and the genotype.

The genome-wide association studies have identified a strong association between interleukin 28B (IL28B) gene polymorphisms and the response to treatment in patients with hepatitis C virus (HCV) infection. The aim of the study was to evaluate the association between three most widely studied IL28B gene polymorphisms and the response to antiviral treatment of chronic hepatitis C. We performed the genotyping of the three IL28B gene polymorphisms: rs12979860, rs8099917, and rs12980275 in 72 Caucasian patients with chronic hepatitis C, previously treated with the combination therapy of pegylated interferon alpha (PEGIFN α) and ribavirin (RBV). The patients included in the study had finished the treatment regimen at least 6 months before enrolling in the study. We used the sustained viral response (SVR) for the evaluation of the effectiveness of the antiviral treatment, and it was tested with an assay with a sensitivity of 20 IU/mL. An SVR was achieved in 59.7% (43/72) of the treated patients. The three IL28B gene polymorphisms (CC genotype of rs12979860, TT genotype of rs8099917, and AA genotype of rs12980275) were associated with the SVR (p=0.029, p=0.016, and p=0.028, respectively) in the study patients with chronic hepatitis C treated with the combination therapy of PEGIFN α and RBV. The association of IL28B gene polymorphisms with the treatment response points to the possibility of personalized medicine for the treatment of HCV infection.

Background: Nowadays PPI present cornerstone in the medical therapy of bleeding peptic ulcer. Controlled pantoprazole data in peptic ulcer bleeding are few., Aim: To compare the effect of intravenous (iv) pantoprazole (PPI) with iv ranitidine (H2RA) for bleeding peptic ulcers after endoscopic therapy., Methods: After endoscopic haemostasis, 122 patients were randomized to PPI 80 mg + 8 mg/h or H2RA 50 mg + 13 mg/h, both for 72 h and to continue with oral equivalent dose of these medicaments. Patients underwent second-look endoscopy on day 3 or earlier, if clinically indicated. The primary endpoint measure was rebleeding before discharge and <14 days of enrollment. Secondary endpoint measures included number of surgeries performed, volume of blood transfusion, mortality rate and hospital stay. All data were statistically analyzed and a value of 0.05 or less was considered to indicate statistical significance., Results: In the group who were treated with PPI, re-bleeding rate was evidenced in 5 patients (8.33%) and in the groups who were treated with H2RA, re-bleeding rate was found in 9 patients (14.5%) with RR 0.27 and CI 0.12-0.60 and P < 0.05. The volume of transfused blood was lower in the group treated with PPI compared to the group treated with H2RA (930 ml vs. 1540 ml and P < 0.05). In this study there was not statistically significant difference in the hospital stay 15.00 vs. 17.80% (9 vs. 11 patients and P> 0.05), the need for surgical intervention 5.00 vs. 6.45% (3 vs. 4 patients and P= 1.00) and the mortality rate 1.66 vs. 3.22% (1 vs. 2 patients and P > 0.05)., Conclusion: A high-dose pantoprazole infusion is more effective than a ranitidine infusion for prevention of re-bleeding after endoscopic epinephrine injection in patients with peptic ulcers and active bleeding or non-bleeding visible vessels (P < 0.05). In all bleeding peptic ulcer patients is needed to make the eradication of H. pylori infection with the aim to prevent re-bleeding in long term.

The Aim of the Study: Gastroesophageal reflux disease is a common disease with a multifactorial pathogenesis. Our aim was to analyse the role of the Gastroesophageal Disease Questionnaire in diagnosing reflux disease in the population of the Republic of Macedonia., Methods: The questionnaire on the severity of the symptoms related to GERD was used. An evaluation of the distal portion of the oesophagus was carried out in all patients with positive questionnaire results. All mucosal injury was classified by the Los Angeles criteria (LA)., Results: 642 patients were included. 58.73% females, with an average age of 37.5±8.2. Females had a higher BMI than males 26.8±4.1 vs. 24.9±3.8 p<0.001. Of the total number of examinees (642 patients), in those with erosive reflux disease and also in those with nonerosive reflux disease, as shown respectively in endoscopy, the sensitivity of the RDQ was 100%, and the specifity was 0%. The100 sensitivity means that the questionnaire verified/diagnosed patients with erosive reflux disease with 100% certainty., Conclusions: RESULTS were found in some studies comparing the positive Reflux Disease Questionnaire and the level of erosive esophagitis (LA classification). This study provides evidence that the RDQ represents a viable instrument for assessing symptom severity and response to treatment in clinical trials of patients with GERD, but in patients with a high score, endoscopic evaluation should not be excluded.

Endoscopic retrograde cholangiopancreatography provides precise imaging of malignant biliopancreatic strictures and allows palliative treatment with endoscopic stenting. Initial successful biliary stenting can be achieved in about 69-100% of patients with pancreatic head malignancies. Preliminary data from our Clinic reported a much lower success rate of endoscopic biliary stenting in obstructive jaundice caused by pancreatic head malignancies. These findings may be because patients are referred at more advanced stages, which could contribute to the lower success rate of biliary stenting. We aimed to determine the success rate of endoscopic biliary stenting prospectively in 50 patients with pancreatic head malignancies and to asses if clinical, laboratory and ultrasound findings can be predictive of success and safety in biliary stenting. Initial successful biliary stenting was achieved in 70% of our patients. No major complications (perforation, severe pancreatitis, massive bleeding, death) were noted. We were able to identify factors predictive of a lower success rate which were associated with a more advanced disease and a longer delay before treatment. Based on our results, we conclude that ERCP should be offered without delay as a primary treatment option for all patients with unresectable pancreatic head malignancy and as a possible treatment option in patients with resectable malignancy who are poor candidates for surgery.

This study is a prospective clinical investigation that includes 195 patients (pts), of whom 64 were diagnosed with gastric cancer and endosonographically determined operability. Endosonography is not used in the primary detection and diagnosis of gastric cancer, but as a supplementary method that, besides the basic detection of the presence or absence of a tumour, gives additional information about the extent of the neoplasm. For this investigation the patients were divided into 3 groups. The first group of 58 pts (30%) were those with benign gastric lesions, 18 pts with polyps and 40pts with gastric ulcers respectively. The second groups of 64 pts (32.5%) consisted of those with gastric cancer. According to the endosonographic findings this group consisted of 2 subgroups: 45 operable patients and 19 inoperable patients with gastric cancers. The third group consisted of 73 pts (37.5%) who were without any changes in the gastric wall. The endosonographic findings in the first subgroup that underwent surgery were correlated with the final intraoperative stage and pathohistology, and in the second subgroup they were compared with the operative finding during the palliation procedure and the final diagnosis of the additional investigation. All these qualities make this method useful for the diagnosis, control and follow-up of the findings in all of the stadiums of the disease including the post-operative period.

This study is a prospective clinical investigation that includes 158 patients (pts.), of whom 64 were diagnosed with gastric cancer by EUS in which operability was determinate, and 94 pts. with gastric submucosal tumours. Endoscopy and pathohistological examination were used in the primary detection and diagnosis of the gastric cancer, and EUS was a supplementary method that revealed additional information about the extent of the neoplasms. According to the findings of the EUS, the patients were divided into 2 groups. The first group consisted of 94 pts (59.5%) with gastric submucosal lesions, and 64 pts (40.5%) with gastric cancer respectively. The first group consisted of 94 pts. with submucosal tumours of the stomach. There were 71 pts with Leiomyoma, 11 pts with Leiomyosarcoma, 7 with an aberrant pancreas, 3 with submucosal cysts, one lipoma and one varix at fundus. The second group consisted of 64 pts (40.5%) with gastric cancer. According to the EUS findings this group was divided into two subgroups: 45 operable patients and 19 inoperable patients with gastric cancer. EUS proved a useful method for the diagnosis and follow-up of the patients with gastric cancer, as well as the staging of the tumour and follow-up during the post-operative period, and with submucosal tumours.

This study is a prospective clinical investigation that includes 587 patients aged on average 55.3 years with symptoms such as perirectal pain, rectal bleeding, and change in bowel habit and tenesmus that had been investigated at the Clinic. Rectal cancer was diagnosed by endoscopy and pathohistologically confirmed in 377 cases. Demonstration of tumor, extension into perirectal fat and lymph node involment were evaluated. Tumors were successfully imaged by endorectal ultrasound. According to the endosonographical results patients were divided into 3 groups: operable, consisting of 168 pts (29%), inoperable group of 205 pts. (35%) and control group with 214 pts (36%). However, transrectal sonography as a usable supplementary method has to provide approximate sensitivity as the method to which it is supplementary, in fact to be able to detect the lesion that was proved beyond doubt in this study. The results suggest that transrectal sonography has an important role in the determination of the operability of rectal malignoma, following and predicting of the degree of infiltration and determining of the precise borders of the intramural infiltration.