INFLUENCE OF HORMONAL STATUS AND MENSTRUAL CYCLE PHASE ON PSYCHOPATOLOGY IN ACUTE ADMITTED PATIENTS WITH SCHIZOPHRENIA

Background: The gender differences in onset, symptom severity, and outcome of schizophrenia are now thought to support the hypothesis that sex hormones may also have a role in etiology, as well as treatment, of schizophrenia. A number of reproductive hormones may be implicated, including testosterone, progesterone, or luteinising hormone, and thus it is important to acknowledge that there is a complex interplay of hormones occurring. This study was introduced to highlight the effect of the menstrual cycle, and sex hormones on female patients with schizophrenia. Subjects and methods: The sample consisted of 31 consecutively acute admitted women, aged 18 to 45 years with schizophrenia diagnosed by DSM-5 criteria. The sample consisted of women who were regulary menstruating and to be undergoing regular hormonal fluxes. Each subject was enrolled and received psychopathology and hormone (estradiole, progesterone, testosterone) assessments. Psychopathology was measured with Positive end Negative Syndrome Scale (PANSS). The subjects were divided into folicular (high estrogen) and luteal (low estrogen) phase admissions. Data were analyzed by regression analysis and t-test for independent samples. Values are given as means ±SD. Results: There were no differences between the folicular and luteal phase admission grups with regard to age, duration of illness and age at onset of illness. We found that significantly more women were admitted during the luteal (low estrogen) phase of menstrual cycle (68%) as compared to follicular (high estrogen) phase (32%). Conclusion: There was a significant increase in hospital admissions in the luteal phase of menstrual cycle in women suffering from exacerbation of schizophrenia. The influence of particulary sex hormones (estrogen, progesterone and testosterone) on admission rate and clinical psychopatology was found insignificant

Psychiatric Patient and Obesity

Debele osobe i osobe s prekomjernom tjelesnom težinom imaju više psihičkih poremećaja u usporedbi s osobama normalne tjelesne težine. Debljina je jedan od najčešćih tjelesnih problema u osoba oboljelih od teških i dugotrajnih psihičkih bolesti i poremećaja. Dok je prevalencija debljine u općoj populaciji 20 – 30%, prevalencija debljine u populaciji oboljelih od shizofrenije jest između 40 – 60%. Debljina se kod osoba oboljelih od shizofrenije povezuje s karakteristikama i značajkama same bolesti kao što su loše i nezdrave prehrambene navike, sjedilački način života, socijalno povlačenje, psihomotorna usporenost i činjenica da mnogi psihotropni lijekovi (antipsihotici, stabilizatori raspoloženja i antidepresivi) koji se rabe u liječenju ove bolesti povećavaju tjelesnu težinu. U liječenju debljine kod psihijatrijskih bolesnika mogu se primjenjivati farmakološke i nefarmakološke metode.Mental disorders are more common among obese and overweight people than among people with normal body weight. Obesity is one of the most frequent physical health problems found in patients suNering from severe and chronic mental disorders. Obesity prevalence in general population ranges from 20% to 30%, while in patients with schizophrenia it ranges from 40% to 60%. Obesity in patients with schizophrenia is associated with the characteristics and nature of the disorder, such as bad eating habits, sedentary lifestyle, social withdrawal and psychomotor retardation. In addition, a number of psychotropic medications used to treat schizophrenia (antipsychotics, mood stabilizers and antidepressants) cause weight gain. Both pharmacological and non-pharmacological methods are available for the treatment of obesity in patients with mental disorders

INFLUENCE OF SERUM TESTOSTERONE LEVEL ON AGGRESSION IN WOMEN WITH SCHIZOPHRENIA

Background: Unlike in female population, the effect of testosterone on aggression in men has been investigated countless times so far. A scarce number of studies have examined the effect of testosterone on aggression in women. The results obtained so far are inconsistent for some studies indicated a positive, whilst others showed a negative correlation. Since testosterone turned out to be an important factor related to aggression in men, the aim of our study was to investigate whether this correlation existed in aggressive female patients with schizophrenia. Subjects and methods: The sample consisted of 120 women, aged from 18 to 45 years, diagnosed with schizophrenia by DSM-5 criteria. Those who were breastfeeding or suffered from specific hormonal or other physical disorders were excluded from the study. They were divided into two groups of 60 - those with aggressive behavior and those with nonaggressive behavior. Psychopathology was measured by several tests (Positive and Negative Syndrome Scale - PANSS, Overt Aggression Scale - OAS and PANSS Extended Subscale for Aggression Assessment). Serum testosterone hormone assays were performed. Statistical data analysis was done by parametric statistical tests, Kolmogorov-Smirnov test, Student\u27s t-test and simple linear regression. All data were presented as mean values and corresponding standard deviations (SD). Results: Testosterone levels didn\u27t differ significantly between aggressive and nonaggressive subjects. There were no significant differences between testosterone levels in suicidal aggressive subjects compared to nonsuicidal aggressive respondents (t=0.616; p=0.540). The largest number of subjects in both groups had referent testosterone levels. Conclusions: Despite expecting a significant effect of testosterone levels on aggression in women with schizophrenia, conducted by previous studies, no correlation has been found testosterone levels

Dementia and Psychiatric Emergencies in the Elderly Population

S obzirom na kontinuirano povećanje broja starijih osoba u ukupnoj populaciji u Hrvatskoj, za očekivati je da će se broj starijih osoba s akutnim psihičkim smetnjama koje zahtijevaju hitno zbrinjavanje sve više povećavati. Najčešći psihički poremećaji kod starijih osoba su: depresivni poremećaji, kognitivni poremećaji, demencija, poremećaji vezani uz uzimanje alkohola, poremećaji vezani uz druga zdravstvena stanja i lijekovima izazvani poremećaji. Gerijatrijski bolesnici bi u pravilu prvo trebali biti pregledani od strane stručnjaka somatske medicine (internista, neurologa, kirurga) prije nego što se upućuju u hitnu psihijatrijsku službu, kako bi se ustanovilo da su primarne smetnje iz psihijatrijske domene. Izražena depresija, suicidalnost, agitacija, sklonosti lutanju i ostalim rizičnim ponašanjima kod kuće, izražena anksioznost i smanjena sposobnost brige o sebi, glavni su razlozi hospitalizacije kod ovih bolesnika.Related to the fact of the continuous increase in the number of elderly people in the total population of Croatia, it can be expected that the number of elderly people with acute psychiatric disorders that require emergency care will increase. The most common psychiatric disorders found in the elderly are depressive disorders, cognitive disorders, dementia, alcoholrelated disorders, disorders related to other health conditions and drug-induced disorders. Geriatric patients should, generally speaking, first be reviewed by a psychosomatic medical specialist (internist, neurologist, surgeon) before they are sent to psychiatric emergency services in order to establish that the primary complaint is connected with the psychiatric domain. Pronounced depression, suicidality, agitation, wandering tendencies and other home-based risk behaviours, with anxiousness and reduced self-care ability, are the main reasons for hospitalization

Idrocarburi policiclici aromatici (IPA) nei prodotti a base di carne affumicata tradizionalmente

Dimljeni mesni proizvodi čine jednu od najvažnijih skupina tradicionalnih namirnica. Zahvaljujući jedinstvenim i povoljnim organoleptičkim svojstvima te visokoj kvaliteti, potrošači ih rado biraju. U posljednje vrijeme raste zabrinutost oko zdravstvenih aspekata ovih proizvoda. Istraživanja sugeriraju da tradicionalno dimljeni mesni proizvodi mogu biti povezani s nekim problemima zdravstvene sigurnosti, poput prisutnosti policikličkih aromatskih ugljikovodika (PAH). Policiklički aromatski ugljikovodici predstavljaju veliku skupinu kemijskih spojeva prepoznatu kao mogućeg uzročnika nastanka malignih oboljenja a mogu nastati tijekom toplinske obrade hrane tradicionalnim postupcima kao što su sušenje i dimljenje. Postoje različiti mehanizmi nastanka PAH-a, pri čemu svi spojevi koji sadrže ugljik i vodik mogu poslužiti kao prekursori nastanka PAH-ova Tijekom reakcija nastanka PAH-a, vodik i ugljik spajaju se u ciklički spoj s izmjeničnim jednostrukim i dvostrukim vezama, s dva ili više kondenziranih aromatskih prstenova, koji daju visok karcinogeni i mutageni potencijal.Stoga je cilj ovog istraživanja bio analizirati čimbenike koji utječu na kvalitetu i zdravstvenu ispravnost tradicionalnih mesnih proizvoda u pogledu sadržaja policikličkih aromatskih ugljikovodika na temelju dostupne literature.Smoked meat products form one of the most important groups of traditional foods. Thanks to their unique and favourable organoleptic properties and high quality, consumers readily choose them. Recently, there has been a growing concern regarding the health aspects of these products. Research suggests that traditionally smoked meat products may be associated with some health safety concerns, such as the presence of polycyclic aromatic hydrocarbons (PAH). Polycyclic aromatic hydrocarbons represent a large group of chemical compounds recognised as a possible cause of malignant diseases, and they can be formed during the heat treatment of food by traditional methods such as drying and smoking. There are different mechanisms for the formation of PAHs, whereby all compounds containing carbon and hydrogen can serve as precursors for the formation of PAHs. During the PAH formation reactions, hydrogen and carbon are combined into a cyclic compound with altering single and double bonds, with two or more condensed aromatic rings, which give a high carcinogenic and mutagenic potential. Therefore, the aim of this research was to analyse the factors that influence the quality and health related safety issues of traditional meat products with regard to the content of polycyclic aromatic hydrocarbons, based on the available literature.Geräucherte Fleischerzeugnisse sind eine der wichtigsten Gruppen von traditionellen Lebensmitteln. Dank ihrer einzigartigen und günstigen organoleptischen Eigenschaften und ihrer hohen Qualität werden sie von den Verbrauchern gerne gewählt. In letzter Zeit wächst die Besorgnis über die gesundheitlichen Aspekte dieser Produkte. Forschungsergebnisse deuten darauf hin, dass traditionell geräucherte Fleischerzeugnisse mit einigen gesundheitlichen Bedenken in Verbindung gebracht werden können, z. B. mit dem Vorhandensein von polyzyklischen aromatischen Kohlenwasserstoffen (PAK). Polyzyklische aromatische Kohlenwasserstoffe stellen eine große Gruppe chemischer Verbindungen dar, die als mögliche Ursache bösartiger Erkrankungen anerkannt sind und sich bei der Wärmebehandlung von Lebensmitteln durch traditionelle Verfahren wie Trocknen und Räuchern bilden können. Es gibt verschiedene Mechanismen für die Bildung von PAK, wobei alle Verbindungen, die Kohlenstoff und Wasserstoff enthalten, als Vorläufer für die Bildung von PAK dienen können. Während der PAK-Bildungsreaktionen werden Wasserstoff und Kohlenstoff zu einer zyklischen Verbindung mit wechselnden Einfach- und Doppelbindungen und zwei oder mehr kondensierten aromatischen Ringen kombiniert, die ein hohes karzinogenes und mutagenes Potenzial aufweisen. Ziel dieser Untersuchung war es daher, auf der Grundlage der verfügbaren Literatur die Faktoren zu analysieren, die die Qualität und die gesundheitliche Unbedenklichkeit traditioneller Fleischerzeugnisse im Hinblick auf den Gehalt an polyzyklischen aromatischen Kohlenwasserstoffen beeinflussen.Los productos cárnicos ahumados forman uno de los grupos más importantes de alimentos tradicionales. Gracias a sus propiedades organolépticas únicas y favorables y su alta calidad, los consumidores los eligen fácilmente. Recientemente, ha habido una preocupación creciente con respecto a los aspectos sanitarios de estos productos. La investigación sugiere que los productos cárnicos ahumados tradicionalmente pueden estar asociados con algunos problemas de seguridad sanitaria, como la presencia de hidrocarburos aromáticos policíclicos (HAP). Los hidrocarburos aromáticos policíclicos representan un gran grupo de compuestos químicos reconocidos como posibles causantes de enfermedades malignas y pueden formarse durante el tratamiento térmico de los alimentos utilizando métodos tradicionales como el secado y el ahumado. Existen diferentes mecanismos de formación de HAP, por lo que todos los compuestos que contienen carbono e hidrógeno pueden servir como precursores de formación de HAP. Durante las reacciones de formación de HAP, el hidrógeno y el carbono se unen en un compuesto cíclico con enlaces simples y dobles alternados, con dos o más anillos aromáticos condensados, que le otorgan un alto potencial carcinógeno y mutagénico. Por lo tanto, el objetivo de esta investigación fue analizar los factores que influyen en la calidad y la seguridad sanitaria de los productos cárnicos tradicionales en cuanto al contenido de hidrocarburos aromáticos policíclicos conforme a la literatura disponible.I prodotti a base di carne affumicata costituiscono uno dei gruppi più importanti di cibi tradizionali. Grazie alle loro proprietà organolettiche uniche e apprezzatissime e alla loro alta qualità, sono molto amati dai consumatori. Nonostante ciò, da qualche tempo preoccupano non poco alcuni aspetti sanitari di questi prodotti. Varie ricerche suggeriscono, infatti, che i prodotti a base di carne affumicata tradizionalmente possono essere associati ad alcuni problemi di sicurezza sanitaria, come la presenza di idrocarburi policiclici aromatici (IPA). Gli idrocarburi policiclici aromatici rappresentano un ampio gruppo di composti chimici che possono formarsi durante il trattamento termico degli alimenti con metodi tradizionali come l\u27essiccazione e l\u27affumicatura, riconosciuti come possibile causa di patologie maligne. Esistono diversi meccanismi di formazione degli IPA, per cui tutti i composti contenenti carbonio e idrogeno possono fungere da precursori della formazione degli IPA. Durante le reazioni di formazione degli IPA, idrogeno e carbonio si uniscono in un composto ciclico con legami singoli e doppi alternati, con due o più anelli aromatici condensati, che conferiscono un elevato potenziale cancerogeno e mutageno. Pertanto, lo scopo di questa ricerca è stato quello di analizzare i fattori che influenzano la qualità e la salubrità dei tradizionali prodotti a base di carne per quanto riguarda il contenuto di idrocarburi policiclici aromatici sulla base della letteratura disponibile

PASSIVE SMOKING – ACTIVE KILLER

Pasivno pušenje javnozdravstveni je problem od iznimne važnosti, iako se takvim još i sad nedovoljno percipira. Svjetska zdravstvena organizacija procjenjuje da od posljedica pasivne izloženosti duhanskom dimu svake godine umre 600.000 ljudi, od čega 165.000 djece. Na udaru je pušačkog dima 33% muškaraca, 35% žena i 40% djece koja ne puše, a samo 11% svjetske populacije zaštićeno je prikladnom politikom usmjerenom kreiranju okruženja bez duhanskog dima. Znanstvena literatura donosi dokaze da pasivno pušenje može rezultirati brojnim posljedicama štetnim za zdravlje: astmom i alergijama, infekcijama dišnog sustava i (srednjeg) uha, karcinomima različitih lokalizacija, ubrzanim razvojem ateroskleroze i kardiovaskularnih bolesti, zaostajanjem u rastu i razvoju djece, a u trudnoći može dovesti do kongenitalnih anomalija čeda, preuranjenog porođaja te manje porođajne mase i duljine djeteta. Najstrašnija od svih posljedica svakako je sindrom iznenadne smrti dojenčeta, tzv. »smrt u kolijevci«. Politike usmjerene kreiranju okruženja bez duhanskog dima pokazale su svoju učinkovitost i znanstvenu osnovanost, no usporedo s donošenjem zakona potrebno je raditi na podizanju svijesti građana o štetnosti i aktivnog i pasivnog izlaganja duhanskom dimu.Although still not perceived in this way, passive smoking is a public health issue of great importance. World Health Organization estimates that as a result of passive exposure to tobacco smoke each year 600,000 people die, of which 165,000 children. There are 33% of men, 35% of women and 40% of children who do not smoke, but are exposed to second hand smoke, and still only 11% of the world population is protected by adequate smoke-free legislation. Scientific literature provides evidence that passive exposure to tobacco smoke can result in numerous adverse health effects: asthma and allergies, respiratory infections and (middle) ear infections, cancers of various localization, accelerated atherosclerosis and cardiovascular diseases, retardation of growth and development in children, and in pregnancy it can lead to congenital anomalies and premature birth as well as lower body weight and length of the child. Certainly, the scariest consequence of all is sudden infant death syndrome, also called »death in the crib«. Smoke-free policies have proven their effectiveness, but while implementing the laws, it is necessary to raise public awareness of the hazards of, both active and passive, exposure to tobacco smoke

Difficulties of Caregivers of Individuals Suffering from Alzheimer’s Disease

U današnjem društvu postoji jasan trend porasta broja osoba starije životne dobi pa time i sve veća statistička značajnost broja osoba oboljelih od Alzheimerove bolesti što generira povećanu potrebu adekvatne skrbi za oboljele. Uz formalne oblike skrbi (pružene od profesionalaca iz sustava zdravstvene i socijalne skrbi), neformalna njega značajan je resurs u pružanju skrbi osobama s demencijom. Neformalni njegovatelji su pojedinci koji se dobrovoljno brinu za člana obitelji ili prijatelja koji se suočava sa bolešću, invaliditetom ili bilo kojim drugim stanjem koje zahtijeva posebnu pažnju. S obzirom na tijek i duljinu trajanja Alzheimerove bolesti i sama skrb za oboljelog je dugotrajna i iscrpljuća, a uključuje sve razine funkcioranja njegovatelja pa ju je potrebno sagledavati u kontekstu kako ekonomskog, tako i emocionalnog, mentalnog i fizičkog stanja njegovatelja. Iako može imati i neke blagotvorne aspekte, skrb za oboljeloga je obično vrlo stresna i može u značajnoj mjesti utjecati na zdravlje i dobrobit njegovatelja te je stoga potrebno razmotriti probleme i opterećenja s kojima se susreću njegovatelji osoba oboljelih od Alzheimerove bolesti.In modern society, the number of elderly individuals is higher and so is the statistical significance of people living with Alzheimer’s disease. This trend results in a higher demand for adequate care for such patients. Along with formal care (provided by social workers and other health care professionals), informal care has become a significant resource in the nursing of individuals with dementia. Informal caregivers are individuals who voluntarily attend to the needs of a family member or a frend living with illness, handicap, or any other condition that requires special needs. Considering the course and duration of Alzheimer’s disease, the nursing of patients can also be lengthy and exhausting. Moreover, all aspects of a caregiver’s job must be taken into consideration starting the mental, emotional, and physical health to nursing expences. Although there are positive aspects, nursing an individual with dementia is extremely stressful and significantly affect the health and wellbeing of the caregiver, and therefore it is necessary to take into consideration all difficulties and problems caregivers of people living with Alzheimer’s disease may encounter

Aggression in Women with Schizophrenia Is Associated with Lower HDL Cholesterol Levels

This study assessed the association between serum lipid levels and aggression in female patients with schizophrenia. The study included female patients with schizophrenia (N = 120). The participants were subdivided into two groups (aggressive and nonaggressive), with 60 participants in each group. Serum lipids—cholesterol, triglycerides, high-density lipoproteins (HDL cholesterol), and low-density lipoproteins (LDL cholesterol)—were determined. The clinical part of the study included an evaluation using psychiatric scales: the positive and negative syndrome scale (PANSS), the aggression subscale of the PANSS scale (PANSS-AG), and the overt aggression scale (OAS). Significant differences were only observed in HDL cholesterol levels, where aggressive subjects had significantly lower values of HDL cholesterol (t = 2.540; p = 0.012), and the representation of subjects with low cholesterol values was almost three-times higher in the group of subjects with aggression (χ2 = 7.007; p = 0.008) compared to the nonaggressive group. The nominally significant predictor for HDL cholesterol in nonaggressive and aggressive participants was the total value of the PANSS scores. In subjects with aggression, suicidality was not significantly associated with HDL cholesterol levels. Our findings suggest that lower HDL cholesterol is significantly associated with aggression in women with schizophrenia