18 research outputs found
EJACULATORY DYSFUNCTION IN PATIENT WITH SCHIZOPHRENIA ON SERTINDOLE
The antipsychotic drugs can be of great benefit for the wide range of psychotic disorders, but all are associated with various
adverse effects. Patients with psychotic disorder consider the sexual dysfunction to be among the most important side effects.
Although, it is not uncommon for the patients with schizophrenia to report the sexual dysfunction, patients with untreated
schizophrenia have fewer dysfunctions compared to those on antipsychotic medication. The decision whether the current treatment
with a prolactin-increasing antipsychotic or sexual dysfunction inducing drug should be continued or switched to another
antipsychotic drug, has to be made on the basis of the patient\u27s risk-benefit estimation. It has to be kept on mind that adverse effects
are usually dose dependent. In this case report, sertindole treated patient with chronic schizophrenia developed sexual side effect
manifested as ejaculatory dysfunction that was significantly ameliorated by drug-dose reduction
Dementia and Mental Disorders
Pojava psihiÄkih simptoma u osoba koje boluju od Alzheimerove bolesti i drugih demencija jedan je od veÄih izazova u skrbi za oboljele. PsihiÄki poremeÄaji u smislu depresije, psihotiÄne dekompenzacije stanja i delirija superponiranog na demenciju mogu znatno utjecati na kognitivne funkcije, ubrzati njihovu deterioraciju i odraziti se na funkcioniranje osoba s demencijom i njihovu samostalnost u aktivnostima svakodnevnog života. PsihiÄki simptomi u okviru pojedinih kliniÄkih slika (primjerice, depresivne ili psihotiÄne) nalažu intervencije u planu lijeÄenja osoba s demencijom, primjenu psihofarmaka i niza nefarmakoloÅ”kih metoda, kao i lijeÄenje tjelesnog komorbiditeta uz razmjerno visok rizik od pojave nuspojava, interakcija lijekova i razliÄitih komplikacija.The appearance of psychiatric symptoms in patients suffering from Alzheimerās disease and other dementia is a great challenge. Mental disorders such as depression, psychotic decompensation and delirium superimposed on dementia may significantly affect cognitive functions, accelerate deterioration and negatively affect the functioning and the independence in activities of daily life. Mental symptoms within certain clinical pictures (eg, depressive or psychotic) in people with dementia require treatment through the use of psychopharmaceuticals and a range of non-pharmacological methods, as well as the treatment of somatic comorbidities with a relatively high risk of side effects, drug interactions and various complications
Delirium superimposed on dementia Ī£ clinical picture and recommendations for treatment
Älanak donosi pregled najnovije literature o deliriju superponiranom na demenciju, ukljuÄujuÄi sadaÅ”nje
spoznaje o patofiziologiji te raspravu o aktualnim preporukama koje se koriste pri dijagnosticiranju i lijeÄenju
delirija. Delirij je sindrom koji se pojavljuje u svim dobnim skupinama i na mnogim bolniÄkim odjelima,
a najÄeÅ”Äi je u jedinicama intenzivnog lijeÄenja. Unutar psihijatrije posebno je znaÄajan kod osoba starije
životne dobi s Alzheimerovom i drugim demencijama. Uvijek intrigantan, na preklapajuÄem podruÄju
somatske medicine, neurologije i psihijatrije, delirij je fenomen koji se javlja naglo, dramatiÄno po kliniÄkoj
slici te obvezuje na brzu reakciju, prepoznavanje i lijeÄenje na bolniÄkom odjelu. U ovom tekstu zbog
Å”irine cijelog podruÄja, usmjerit Äemo se na dijagnosticiranje i lijeÄenje delirantnih stanja kod gerijatrijskih
psihijatrijskih bolesnika od demencije.This article reviews the recent literature about delirium superimposed on dementia, including current
knowledge about pathophysiology and the discussion on current recommendations that are used in
diagnosing and treating delirium. Delirium is a syndrome occurring in all age groups at different hospital
wards, and is most common in the intensive care units. In psychiatry, it is most relevant to older patients
with Alzheimerās and other types of dementia. Always intriguing, traddling the borders of somatic medicine,
neurology and psychiatry, delirium is a phenomenon occurring abruptly, with a dramatic clinical picture, and
committing us to quick reaction, recognition and treatment at the hospital ward. In this article, because of
the broadness of the topic, we will focus on diagnosis and treatment of delirium within geriatric psychiatric
patients suffering from dementia
The Antimetastatic Effect of Macrophages Restored by Indomethacin: Concomitant Tumor Immunity Model
The role of macrophages acting as immunologic antitumor effectors and promoters of tumor growth are poorly understood as yet. We investigated the role of macrophage in model of concomitant immunity (CI), a phenomenon of secondary tumor rejection during the primary tumor growth. It has been shown that the period of CI weakening can coincide with appearance of tumor metastases. We used mammary carcinoma (MC) artificial lung metastases to evaluate the influence of macrophages from various period of CI on the development of metastases in mice. Our results indicated that macrophages are responsible for the late period of CI weakening and suppression. To investigate weather prostaglandins can mediate suppressive effect of macrophages we used experiments with indomethacin and we found that inhibition of prostaglandin E2 synthesis by indomethacin restored antimetastatic effect of concomitant immune macrophages
SEXUAL SIDE EFFECTS OF ANTIPSYCHOTICS
Istraživanja su pokazala da seksualna disfunkcija kao nuspojava lijeÄenja psihofarmacima bitno utjeÄe na kvalitetu života i održavanje partnerskih veza. Rezultati istraživanja pokazuju da simptomi seksualne disfunkcije koji se javljaju tijekom lijeÄenja viÅ”e zabrinjavaju psihiÄke bolesnike nego ekstrapiramidni simptomi. Seksualne disfunkcije opisane su kod 50 % bolesnica na terapiji psihofarmacima. UnatoÄ miÅ”ljenju veÄine psihijatara da je seksualno funkcioniranje važno za pacijente, dvije treÄine psihijatara uobiÄajeno ne postavlja pacijentima pitanja o seksualnom funkcioniranju. Stoga se seksualna disfunkcija kao nuspojava psihofarmaka nedovoljno Äesto prepoznaje i lijeÄi. AtipiÄni antipsihotici imaju brojne potencijalne prednosti u odnosu na tipiÄne antipsihotike s obzirom na njihov uÄinak na seksualno funkcioniranje. Pažnju je potrebno usmjeriti na hiperprolaktinemiju tijekom dugotrajnog lijeÄenja, posebno kod primjene visokih doza, osoba ženskog spola, osoba s ranijim poÄetkom bolesti i kod teÅ”kih bolesnika. Prema rezultatima istraživanja podatci ukazuju da se povezanost izmeÄu seksualne disfunkcije i psihopatologije odnosila samo na žene. Stoga, prigodom voÄenja brige o pacijentima osnovno je razmotriti spolno-specifi Äne odnose izmeÄu psihopatologije i seksualnih problema. Kod muÅ”karaca lijeÄenih antipsihoticima opisane su razliÄite vrste seksualnih disfunkcija ukljuÄujuÄi erektilnu, ejakulatornu i orgazmiÄku. Seksualnoj disfunkciji induciranoj antipsihoticima treba pristupiti uvažavajuÄi osjetljivost i individualne potrebe svakog bolesnika. ZakljuÄno možemo reÄi da su seksualne disfunkcije kod primjene novijih antipsihotika znaÄajan i Äesto slabo prepoznati problem. Adekvatnim izborom atipiÄnog antipsihotika s odgovarajuÄim farmakoloÅ”kim profi lom smanjuje se moguÄnost pojave seksualnih poteÅ”koÄa. BuduÄa istraživanja novih lijekova trebaju uzeti u obzir javljanje seksualnih disfunkcija.Investigations have shown that sexual dysfunction as a side effect of treatment with psychopharmaceuticals signifi cantly infl uences the quality of life and maintenance of relationships between partners. Results of investigations show that symptoms of sexual dysfunction that occur during treatment upset psychiatric patients more than extrapyramidal symptoms. Sexual dysfunction is described in 50% of female patients during therapy with psychopharmaceuticals. Despite the opinion of the majority of psychiatrists that sexual functioning is important for patients, two-thirds of psychiatrists usually do not ask patients questions about sexual functioning. Therefore, sexual dysfunction as a side effect of psychopharmaceuticals frequently is inadequately recognized and treated. Atypical antipsychotics have numerous potential advantages in comparison
with typical antipsychotics regarding their effect on sexual functioning. Attention should be focused on hyperprolactinemia during long-term treatment, especially when applying high dosages, females, persons with earlier onset of illness, and in severely ill patients. According to results of investigations, data indicate that the connection between sexual dysfunction and psychopathology referred only to women. Therefore, considering gender-specifi c relations between psychopathology and sexual problems is elementary during medical care for patients. Different types of sexual dysfunction, including erectile, ejaculatory and orgasmic, have been described in men during treatment with antipsychotics. Sexual dysfunction induced by antipsychotics should be addressed, taking into consideration sensitivity and individual needs of each patient. In conclusion, we may say that sexual dysfunctions are an important and often poorly recognized problem in the treatment with newer antipsychotics. The probability of the occurrence of sexual disturbances is decreased by correct choice of atypical antipsychotic with appropriate pharmacological profi le. Future investigations of new medications should take the occurrence of sexual dysfunctions into consideration
Dementia is More Frequent in Women
Demencija je sindrom globalnog i progresivnog oÅ”teÄenja steÄenih kognitivnih sposobnosti pri oÄuvanoj svijesti prouzroÄen organskom boleÅ”Äu srediÅ”njeg živÄanog sustava u kojem su posebno oÅ”teÄene sposobnosti pamÄenja, uÄenja, apstraktnog miÅ”ljenja, orijentacije te poimanja vidnoāprostornih odnosa. Prevalencija i incidencija
Alzheimerove bolesti (AB), najÄeÅ”Äeg uzroka demencije, znatno je veÄa kod žena nego kod muÅ”karaca, a ta se razlika s dobi poveÄava. Dvostruko veÄa uÄestalost AB kod žena u odnosu na muÅ”karce djelomiÄno se može objasniti time Å”to žene imaju oÄekivano dulji životni vijek. Žene imaju loÅ”iju kognitivnu izvedbu na mnogim neuropsihologijskim testovima u odnosu na muÅ”karce u istom stadiju bolesti, odnosno viÅ”estruke kognitivne funkcije kod žena teže su i
Å”ire zahvaÄene nego kod muÅ”karaca. MoguÄi razlozi za ovakvu nepovoljnost naspram žena su redukcija estrogena u postmenopauzi, veÄe kognitivne rezerve muÅ”karaca te utjecaj apolipoproteina E. OdreÄeni bioloÅ”ki Äimbenici takoÄer bi mogli objasniti razliÄite kliniÄke manifestacije AB s obzirom na spol. Osim Å”to prema prezentiranim
podatcima žene ÄeÅ”Äe obolijevaju od AB, žene su takoÄer te koje u bitno veÄoj mjeri pružaju neformalnu njegu ljudima s demencijom, te su oko dvije treÄine neformalnih njegovatelja žene. ZakljuÄno, u daljnjem istraživaÄkom i kliniÄkom radu s AB svakako bi trebalo obratiti pozornost na spoznaje o spolnim razlikama u razvoju i progresiji ove bolesti.Dementia is a syndrome of global and progressive impairment of acquired cognitive abilities with preserved consciousness caused by an organic illness of the central nervous system with especially pronounced damage to the ability to memorise, learn, think abstractly, orientate, and perceive spatial relations. The prevalence and incidence of
Alzheimerās Disease (AD), the most common cause of dementia, is considerably greater in women than in men, and that difference increases with age. The fact that AD occurs twice as often in women than in men may be partially explained by a longer life expectancy among women. Women show worse cognitive performance on numerous neuropsychological tests in comparison to men during the same stage of the disease, meaning that multiple cognitive functions are more widely and severely impaired in women than in men. Possible reasons for such unfavourable results among women are a reduction of oestrogen during post-menopause, larger cognitive reserves in men, and the influence of apolipoprotein E. Certain biological factors may also explain various clinical manifestations of AD regarding sex. Apart from the fact that, according to presented data, women develop AD more often than men, women are also those who offer informal care to people with dementia in much greater numbers, and almost two thirds of informal caregivers are women. In conclusion, further research and clinical work with AD should certainly pay attention to insights about sex differences in the development and progression of this disease
Alzheimerās Disease ā Influence on Female Caregiversā Living and Mental Health
Demencija je javnozdravstveni problem koji Äe postati sve vidljiviji kako stanovniÅ”tvo stari. Danas u svijetu živi 50 milijuna ljudi oboljelih od demencije, a procjenjuje se da Äe do 2030. broj oboljelih narasti na 65,7 milijuna, odnosno na 115,4 milijuna oboljelih do 2050. godine. Danas kada demenciju nastojimo dijagnosticirati Å”to ranije, bitno je oboljelima i njihovim obiteljima ponuditi kontinuirani i Å”to kvalitetniji program lijeÄenja i skrbi. U ovom radu željeli smo pokazati koji su glavni problemi vezani uz Alzheimerovu bolest i druge demencije u suvremenom svijetu, a bitno utjeÄu na život žena njegovatelja. Opisan je utjecaj na žene koje skrbe za ljude s demencijom u ulozi profesionalnog njegovatelja i na žene koje preuzimaju ulogu neformalnog njegovatelja osobe oboljele od demencije. Rano prepoznavanje emocionalnog stresa kod njegovatelja nužno je kako bi se uspjelo preventivno djelovati (savjetovanje, suportivna psihoterapija, kognitivno-bihevioralni tretman), te sprijeÄiti razvoj ili pogorÅ”anje
veÄ postojeÄih tjelesnih bolesti (npr. kardiovaskularnih), odnosno mentalnih poremeÄaja od kojih su, osim nesanice, najÄeÅ”Äi anksioznost i depresivnost.Dementia is a public health problem that will become more obvious as the population grows older. There are 50 million people with dementia in the world, and it is estimated that the number of people with dementia will rise to 65.7 million by 2030, and 115.4 million by 2050. At present, we are trying to diagnose dementia as early as possible, and it is important to offer patients and their families a continuous and high-quality program of treatment and care. In this article, we wanted to show the main problems connected with Alzheimerās disease and other dementias in the modern world which influence the lives of female caregivers. The influence on women who take care of people with dementia as professional caregivers, as well as women who take the role of an informal caregiver of a person with dementia has been described. Early recognition of emotional stress in caregivers is necessary for successful preventive actions (counselling, supportive
psychotherapy, cognitive-behavioural treatment) and for preventing the development or worsening of already existing somatic diseases (e.g. cardiovascular), as well as mental disorders, among which, apart from insomnia, anxiety and depression are the most common forms