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Policija na hitan psihijatrijski pregled dovodi najčešće osobe intoksicirane alkoholom
No full textThe aim of this study was to analyze possible the differences in sociodemographic characteristics between the patients intoxicated with alcohol and the other psychiatric patients brought for the urgent psychiatric examination, at the Department for urgent psychiatry, with the police escort, in the years 2001 and 2002. From the total number of 5,534 exams performed at the ambulance for urgent psychiatry in year 2001, and 2002, 282 patient have been brought with the police escort. The police had been bringing the patients, most often man, intoxicated with alcohol. Those patients were mostly observed, or just examined, and committed again to the police station. The rest of the patients were the schizophrenics, the patients who had attempted suicide, and the patients with personality disorders. Those patients mostly remained on coercive hospital treatment, in the accordance with the Croatian Law on Mental Health. The female patients have been brought practically in the same number with the police escort, as the male patients, mostly because of the following disorders: alcohol intoxication, schizophrenia, mood disorders (manic episode), or attempted suicide. In conclusion, our results confirm the criminal element of alcoholism, that has been already pointed out.Cilj ovoga istraživanja jest analizirati razlike u sociodemografskim karakteristikama između pacijenata intoksiciranih alkoholom i ostalih psihijatrijskih pacijenata hitno dovedenih na pregled, u hitnu psihijatrijsku ambulantu, u pratnji policije tijekom 2001. i 2002. godine. Od ukupno 5.534 pregleda, obavljenih u hitnoj psihijatrijskoj ambulanti u 2001. i 2002. godini, 282 pacijenta su dovedena u pratnji policije. Policija je dovodila pacijente koji su većinom bili muškarci intoksicirani alkoholom. Ti pacijenti su češće opservirani ili samo pregledani i ponovno u pratnji policije upućeni u policijsku postaju. Ostali pacijenti uključivali su shizofrene pacijente, pacijente koji su pokušali samoubojstvo i pacijenti s poremećajima osobnosti. Ti pacijenti su većinom ostajali na obveznom bolničkom liječenju i to prisilno, prema Zakonu o zaštiti osoba s duševnim smetnjama. Ženske pacijentice dovedene su gotovo u istom broju u pratnji policije kao i muški pacijenti, zbog sljedećih poremećaja: alkoholna intoksikacija, shizofrenija, poremećaji raspoloženja (manične epizode) ili pokušaja suicida. Naši rezultati potvrđuju dosada već isticanu kriminogenu ulogu alkohola
Elevated Serum Lipids in Veterans with Combat-related Chronic Posttraumatic Stress Disorder
No full textAim. To assess possible differences in serum cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides, arteriosclerosis index, established risk factor (ERF) of arteriosclerosis, and 10-year risk for coronary disease according to the Adult Treatment Panel III (ATP-III) between veterans with combat-related posttraumatic stress disorder (PTSD) and a control group consisting of patients with major depressive disorder.
Method. We determined serum cholesterol, LDL-C, HDL-C, and triglycerides in the patients with PTSD (n=103) and patients with major depressive disorder (n=92), using the enzyme-assay method. AI, ERF, and ATP-III were calculated from cholesterol, LDL-C, and HDL-C levels. The groups were matched in age and body mass index (BMI). Patients with major depressive disorder were chosen as a control group because they do not have changes in serum lipids.
Results. Patients with combat-related PTSD had higher cholesterol (6.21.1 mmol/L vs 5.30.9 mmol/L; p0.001), LDL-C (3.90.7 mmol/L vs 3.51.0 mmol/L; p=0.005), and triglycerides (2.92.3 mmol/L vs 1.50.5 mmol/L; p0.001), and lower HDL-C (1.00.3 mmol/L vs 1.30.2 mmol/L; p0.001) than the control group. Arteriosclerosis index (4.21.2 vs 3.71.7; p =0.050), ERF (6.41.9 vs 5.52.4; p=0.010), and ATP-III (12.13.3 vs 10.23.8; p0.001) were higher in PTSD than in the control group.
Conclusion. Elevated concentrations of serum lipids are associated with combat-related PTSD. This may imply that patients with combat-related PTSD are under a higher risk for arteriosclerosis
Podudarnost između poremećaja smanjene pozornosti / hiperaktivnosti (DSM IV ADHD) i hiperkinetskog poremećaja ICD 10 u uzorku hrvatske dječje populacije
No full textThe aim of the study was to examine directly the extent to which ICD 10 hyperkinetic disorder and DSM IV attention deficit/hyperactivity disorder (ADHD) identify the same children with the same difficulties. Participants were elementary school children (n=409) aged 7-10 years. Diagnostic criteria for ICD 10 hyperkinetic disorder and DSM IV ADHD were applied. Four groups were identified: hyperkinetic disorder and ADHD (n=35), ADHD only (n=27), hyperkinetic disorder only (n=3), and children without any symptoms according to DSM IV and ICD 10 criteria (n=344). The kappa coefficient assessing the agreement between the DSM IV ADHD and ICD 10 hyperkinetic disorder was K=0.66; percent of agreement = 78%. The c2-test yielded c2=250.3 (df=1; p<0.001). The prevalence of DSM IV ADHD and ICD 10 hyperkinetic disorder was 15.16% and 9.3%, respectively. DSM IV was found to identify a broader group of children; however, there was a substantial overlap between the groups formed according to these criteria.Cilj ovoga rada bio je usporediti u kojoj mjeri kriteriji MKB 10 za hiperkinetski poremećaj i poremećaj pozornosti/ hiperaktivnosti (ADHD) prema kriterijima DSM IV prepoznaju istu djecu s istovrsnim smetnjama. Ispitanici su bila djeca osnovnoškolskog uzrasta starosti 7-10 godina (n=409). U analizi su primijenjeni dijagnostički kriteriji prema klasifikaciji MKB 10 za hiperkinetski poremećaj i kriteriji DSM IV za ADHD. Izdvojene su četiri skupine djece: hiperkinetski poremećajem i ADHD (n=35), samo ADHD (n=27), samo hiperkinetski poremećaj (n=3) i djeca bez simptoma prema kriterijima DSM IV i ICD 10 (n=344). Koeficijent podudarnosti između hiperkinetskog poremećaja MKB 10 i DSM IV ADHD bio je K=0.66; postotak podudarnosti 78%. c2-test pokazao je statistički značajan rezultat (c2=250.3; df=1; p<0.001). Prevalencija za ADHD prema DSM IV bila je 15.16%, a za MKB 10 hiperkinetski poremećaj 9.3%. Utvrđeno je da DSM IV identificira širu skupinu djece, međutim, nađeno je značajno preklapanje među prepoznatim skupinama djece uz ova dva različita kriterija
Hereditary Protein S Deficiency and Recurrent Venous Thrombosis: A Case Report
No full textA case is presented of a 32-year-old female with hereditary protein S deficiency associated with pulmonary embolism and recurrent deep venous thrombosis of lower extremities. Other proteins known to be associated with familial thromboembolic disease, including antithrombin, plasminogen, fibrinogen, protein C, factor V Leiden and prothrombin G20210A, were normal. Her mother, grandmother and great-grandfather had a history of thromboembolic disease. This report illustrates the importance of protein S measurement in patients suspected of having inherited venous thrombotic disorders
Changes in occurrence of breast cancer in the hospital's registry (1980-2000)
No full textCilj je istraživanja analizirati distribuciju histoloških tipova, dobi i hormonske ovisnosti karcinoma dojke na temelju podataka kompjutorskog sustava »Thanatos« tijekom razdoblja od 1980. do 2000. godine. Istraživano razdoblje smo podijelili u odnosu na ratna događanja (razdoblje prije rata: 1980 - 1990, za vrijeme rata: 1991— 1995. i poslije rata: 1996-2000) i černobilski incident (razdoblje prije: 1980-1986. i poslije: 1987-2000). Interes nam je posebno privuklo ratno razdoblje s obzirom na to da o ratnom stresu, kao induktoru i promotoru karcinogeneze, ima malo dostupne literature. Tijekom razdoblja 1980 - 2000. dijagnosticirano je 2296 bolesnika s karcinomom dojke. Od toga je u žena bilo 2228 (98%) duktalnih i 46 (2%) lobularnih invazivnih karcinoma dojke. U svim slučajevima raka dojke u muškaraca (22 bolesnika) patohistološki se radilo o duktalnom invazivnom karcinomu, a M:Ž omjer bio je 1:103. Uspoređujući razdoblje prije i za vrijeme rata, nalazimo više nego dvostruki porast M/Ž omjera s 1:131 na 1:66. Sličan rezultat dobili smo i u razdoblju nakon černobilskog incidenta kada omjer s 1:139 raste na 1:79. Analizom distribucije histoloških tipova vidimo signifikantan porast pojavnosti lobularnog karcinoma u poslijeratnom razdoblju s 1,1% na 5.5% te uočljiv, ali manje izražen, porast u postčernobilskom razdoblju (s 1,0% na 3,3%). Prosječna dob bolesnica s duktalnim invazivnim karcinomom raste s 56,7 godina u periodu prije rata preko 59,7 u ratu na 61,1 godinu u razdoblju nakon rata. Nasuprot tomu prosječna dob u vrijeme postavljanja dijagnoze, kod muških bolesnika s bolesti otkrivenom u periodu nakon rata, niža je za gotovo 5 godina (58.8 godina) od dobi izračunane za ostala dva razdoblja (63,6 ili 63,5 godina). Uspoređujući stadije bolesti prema pTNM klasifikaciji u ratnom i poslijeratnom periodu, najčešće dijagnosticiran stadij u vrijeme postavljanja dijagnoze duktalnog invazivnog karcinoma dojke bio je T1N0MX, a u kontrolnom periodu (1989-1990) T2N1MX. Time vidimo da naglašeni porast dobi bolesnica nije praćen nalazom kasnijeg pTNM stadija, što ne ide u prilog teoriji o porastu dobi naših bolesnica uzrokovanom kasnijim javljanjem liječniku zbog ratnih previranja. Naši rezultati pokazuju da je većina bolesnica imala pozitivne ER (72%), a pozitivnost i visina koncentracije raste s dobi pacijentica. Utvrdili smo signifikantni pad hormonski visoko ovisnih tumora u periodu od 1991. do 1995, što bi moglo značiti da su bolesnice u ratu manifestirale agresivniji fenotip tumora. Naša studija pokazuje da su ratna događanja na našim prostorima vjerojatno utjecala na promjene nekih kliničkih parametara kod bolesnika s rakom dojke. Mogući utjecaj černobilskog incidenta nije se mogao dokazati, a efekti u postčernobilskom razdoblju vjerojatno su posljedica promjena vezanih uz ratni stres.The aim of our retrospective study was to analyze distribution of histological types, age of patients and hormonal dependency of breast cancer cases in the period 1980-2000 using computer database » Thanatos«. This period was divided with regard to the war into a pre-war (1980—1990), war (1991—1995) and post-war period (1996-2000). We also paid attention to the Chernobyl accident (pre-Chernobyl from 1980-1986 and post-Chernobyl from 1987-2000). Special attention was focused on the period during the war mainly due to the fact that very little data exist in literature dealing with the war as a stress factor that may have induced and promoted carcinogenesis. During this twenty-one year period 2296 patients were diagnosed with breast cancer. In the female population of 2274, 2228 (98%) of these were ductal and only 46 (2%) were invasive lobular carcinomas. In all of the male cases (22) the cancer was pathohistologically verified as the invasive ductal type. The male:female ratio was 1:103. Comparing the pre-war and war periods we found a more than double increase in the male:female ratio (from 1:131 to 1:66). We observed similar results when we looked at the period after the Chernobyl incident where the ratio increased from 1:139 to 1:79. When we analyzed the distribution of histological types we found a significant increase in lobular carcinomas during the post-war period, from 1.1% to 5.5%; this increase was less significant for the post-Chernobyl period (1.0% to 3.3%). The average age of the patients with invasive ductal carcinomas increased from 56.7 yrs during the pre-war period to 59.7 yrs during the war and finally to 61.1 yrs during the post-war period. The average age of males with breast cancer decreased from 63.6 and 63.5 during the pre-war and war periods to 58.8 yrs during the post-war period. These results suggest that the war could have influenced the shift in the age of occurrence of breast cancer in both sexes appearing in younger males and in females in their postmenopausal period. The most commonly diagnosed stage of invasive ductal carcinoma during thw war and post-war periods was T1N0MX, but in the controlled pre-war period the most frequently diagnosed stage was T2N1MX. With this we see that the increase in the age of the patient is not due to a more advanced pTNM stage which suggests that the increased age of our patients seeking medical help is not due to the incapacitating effects that the war may have on people needing medical attention. Our results showed that most of the patients were ER positive (72% throughout the twenty-one year period) and their average rate and number increase with the age of the patient. We found a significant drop in hormone dependent tumors in the period from 1991-95, which could mean that tumors in a war environment manifest a more aggressive phenotype. Our results show that the war within our region most likely had an effect on some clinical parameters involving breast ca patients. Possible effects caused by »Chernobyl« could not be proved due to the overwhelming effect that war had upon the patients within this region
War Injuries of Colon and Rectum – Results After 10 Years
No full textThe aim of our study is to evaluate results of treating war injuries of colon and rectum, after 10 years. During the war in Croatia, 21 wounded, with colon (19) and rectum (2) injuries, were treated in the Department of Surgery at Nova Gradiška General Hospital from August 1991 to April 1992. Bullet wounds accounted for 57% of the injuries. All patients had other associated injuries. Primary repair and proximal derivation was possible in 2 cases (9.5%), while primary resection with intraperitoneal anastomosis was performed in 3 (14.3%) patients. In 2 (9.5%) patients sustained intraperitoneal and extraperitoneal rectal penetrating injury rectum was resected and closed performing temporary sigmoidostomy. When multiple perforations or crush injury of the colon were found, in 8 (38.1%) injured persons resection of the involved segment was combined with proximal end colostomy and aboral mucous fistula. Exteriorization of injured segment of the colon and creating colostomy incorporating the injured colon as the stoma was performed in 6 (28.5%) wounded patients. Four of the wounded (19.0 %) died two of them during the operative procedure due to hemorrhagic shock. One injured died after eight days due to pulmonary embolism, and one patient died after thirty days due to sepsis. Reoperation was necessary in two (9.5%) injured due to bowel obstruction four days following initial surgery because of adhesions. Three (14.3%) of the injured had wound infection, one of them died 30 days after injury due to sepsis, and two (9.5%) consequently developed ventral hernia that was operated after 4 and 5 years respectively. Four (19.0%) of the injured are still occasionally experiencing occasional abdominal pain
Current basis of classification, diagnostics, epidemiology and etiology of attention deficit-hyperactivity disorder
No full textU radu se opisuje povijesni razvoj koncepta poremećaja pažnje-hiperaktivnog poremećaja (ADHD). Prikazani su suvremeni klasifikacijski kriteriji prema MKB 10 i DSM IV te preporuke za dijagnostiku, diferencijalnu dijagnozu te komorbidna stanja ADHD poremećaja. Iznesen je sažetak novijih shvaćanja etiologije ADHD poremećaja.The article deals with the history of conceptualization of attention deficit-hyperactivity disorder. A review is given of the current classification criteria according to ICD 10 and DSM 1V, diagnostic procedure, differential diagnostic criteria, comorbidity and etiology of attention-deficit-hyperactivity disorder
Plućna infekcija izazvana organizmom Nocardia asteroides: prikaz slučaja
No full textPresentation is made of a 53-year-old woman with pulmonary infection caused by Nocardia asteroides. Tracheal aspirate was obtained and examined microbiologically. Direct smear of the tracheal aspirate stained with Gram stain revealed gram-positive branched filamentous hyphae and numerous leukocytes. Pure culture of colonies of a chalky white appearance grew on the blood agar after prolonged incubation. The Gram stained direct slide prepared from the culture showed gram-positive branching filaments. The microorganism was identified as Nocardia asteroides by standard methods.Prikazana je 53-godišnja bolesnica s plućnom infekcijom uzrokovanom mikroorganizmom Nocardia asteroides. Uzet joj je trahealni aspirat i pretražen je mikrobiološki. U direktnom mikroskopskom preparatu iz aspirata traheje bojenom po Gramu vidljive su gram pozitivne razgranate filamentne hife uz puno leukocita. Na krvnom agaru nakon duže inkubacije porasla je čista kultura kolonija bijelog, kredastog izgleda. Preparat iz kulture bojen po Gramu pokazao je gram pozitivne razgranate filamente. Primjenom standardnih metoda mikroorganizam je identificiran kao Nocardia asteroides
An Overview on Anticancer Activities of the Viscum Album Extract Isorel®
No full textThe activity principle of the mistletoe (Viscum album L.) phytotherapeutics could be considered as combined cytotoxic and "biological response modifying" activities (increasing host defense against cancer) that result from the activities of the plant lectins and the other biologically relevant substances. We found before that the aqueous extract Isorel, produced by Novipharm GmbH (Pörtschach, Austria) from the entire plant (planta tota) of fresh mistletoe under standardized conditions with bioassay validated batch consistency, can be valuable in experimental adjuvant cancer therapy increasing efficiency of cyclophosphamide chemotherapy. In current study we found that Isorel increases the reactivity of the tumor-bearing mice lymphocytes to the mitogens (ConA and LPS) in vitro, thus indicating its immune stimulating effects for the cancer-immunosuppressed lymphocytes. Moreover, Isorel inhibited the incorporation of 3H-labelled amino acids (protein synthesis) in various malignant cell lines. For the growth inhibition mostly higher MW components were responsible, although even less than 500 Da components were also active. We further analyzed the effects of drug application in vicinity of tumor (murine mammary carcinoma) and compared it with systemic effects. The animals carried mammary carcinoma in both hind limbs and were also injected with tumor cells i.v. to develop artificial lung metastases. Isorel was applied only at the right side (in the limb distal from the tumor) and caused persistent and almost complete inhibition of the tumor growth for 2/7 animals. Anticancer effects were less pronounced on the contralateral side tumors, although tumor growth rate was transiently reduced for some mice. Histology revealed that Isorel treatment, both at the side of tumor and systemically, increased the incidence of apoptosis and necrosis in the tumors, while reduction of mitosis was noticed only for the tumors in vicinity of the tumor exposed to Isorel. Finally, animals treated with Isorel had, on the average, three times less lung metastases than the controls. Thus, we conclude that both local and systemic effects of the application of Isorel could be of benefit for the tumor-bearing organism resulting in immunomodulation combined with tumor growth inhibition and reduction of metastases. According to the in vitro results, antitumorous effects could be the result not only of the mistletoe lectins and the other high MW factors, but also of the very low MW (< 500 Da) substances that deserve further analyses