Self-assessed needs of the elderly for the non-institutional care services of gerontological centers in relation to their functional ability

Aim of this paper is to determine whether there is a difference between the expressed need and choice of priorities of the non-institutional care services provided by gerontological centres and the category of their functional independence in the elderly who are on the official waiting list for placement in the decentralized Nursing home Split “Vukovarska”.Methods: The research was conducted in November 2021. The participants were aged 65 and over who were on the official waiting list of the Nursing home Split. The research was conducted via telephone survey with the guaranteed anonymity of the participants. The following questionnaires were used: Questionnaire on sociodemographic characteristics, Questionnaire for self-assessment of elderly persons on the need and choice of offered services of non-institutional care, Barthel index modified according to Shah S., Vanclay F. and Cooper B. (MBI).Results: The study included 182 participants. There was a statistically significant difference between the participants’ stated need and choice of priorities for the offered services of the gerontological centre and the category of functional independence of the participants in relation to offered services: help at home (p<0.001); day stay (p<0.001); programs of continuous physical, mental, work, and cultural and entertainment activities (p<0.001); medical, social and psychological services (p<0.002); technical assistance (p<0.001).Conclusions: This study indicates that the functional independence of the elderly is an important gerontological public health indicator in the planning of non-institutional care for the elderly population

Blaži kognitivni poremećaj kao klinička manifestacija neurosarkoidoze lijevka hipofize: prikaz slučaja

A case is presented of a 59-year-old male patient with a 5-year history of sarcoidosis. In the last half a year, deterioration of his intellectual abilities was noticed. Psychological testing detected a mild cognitive disorder. Laboratory diagnostics found a decreased level of testosterone and magnetic resonance imaging showed pituitary stalk neurosarcoidosis without any other pathomorphological substrate of cognitive impairment. This case indicates that neurosarcoidosis should be considered as a possible cause of mild cognitive disorder and, consequently, included in the International Classification of Mental and Behavioural Disorders.Prikazuje se slučaj 59-godišnjeg bolesnika s 5-godišnjom poviješću bolesti sarkoidoze. U posljednjih pola godine primjetno je bilo slabljenje njegovih intelektualnih sposobnosti. Psihološkim testiranjem otkriven je blaži spoznajni poremećaj. Laboratorijskom dijagnostikom utvrđena je snižena razina testosterona, dok je magnetska rezonancija pokazala neurosarkoidozu lijevka hipofize bez ikakvog drugog patomorfološkog supstrata kognitivnog poremećaja. Ovaj slučaj pokazuje da neurosarkoidozu treba uzeti u obzir kao mogući uzrok blažeg spoznajnog poremećaja, pa bi je trebalo uvrstiti u Međunarodnu klasifikaciju psihičkih bolesti i bolesti ponašanja

Probiotici i prebiotici kod arterijske hipertenzije

There is growing evidence that a disturbed microbiota, a complex ecosystem, is associated with the development of numerous diseases, including arterial hypertension. This complex cardiovascular disease is the result of not sufficiently clear role that genetic and environmental factors play in it. Not only does the treatment of hypertension include a drug therapy, but also it includes a variety of non-pharmacological measures based on dietary intervention. Probiotics and prebiotics are besides the nutrition the most commonly used substances that are aimed at maintaining a healthy microbiome or restoring the balance in case of disturbed bacterial homeostasis in disease. Although many studies have confirmed the effects of an imbalance in the gut microbiota (dysbiosis) in the last decade, the benefits of dietary intervention with probiotics in people with hypertension need to be supported by stronger evidence and further clinical trials in order to be ultimately confirmed.Sve je više dokaza da je narušen sustav ljudske mikrobiote, kompleksnog eko sistema, povezan s patogenezom brojnih bolesti, među ostalim i arterijske hipertenzije (AH). Ova kompleksna kardiovaskularna bolest rezultat je još uvijek nepotpuno jasne uloge genetskih i okolišnih čimbenika. Liječenje AH pored medikamentnog liječenja obuhvaća i višestruke nefarmakološke mjere čiji temelj predstavljaju dijetalne intervencije. Najčešće korištene tvari kojima se nastoji održati zdrav mikrobiom ili uspostaviti ravnoteža pri poremećenoj bakterijskoj homeostazi u bolesti su, osim prehrane, probiotici i prebiotici. Iako mnoga istraživanja u zadnjem desetljeću potvrđuju učinak disbalansa crijevne mikrobiote (tzv. disbioze), za definitivnu potvrdu dobrobiti dijetalne intervencije probioticima kod osoba s AH, potrebni su snažniji dokazi te daljnja klinička istraživanja

Vegetable by-products in the European food legislative framework

Vegetable by-products are a source of many useful bioactive compounds, dietary fiber, fatty acids and proteins that have a great potential in the development of new food products and the promotion of the circular economy and sustainability. Considering processed pepper by-products as an example, the aim of this paper is to provide an overview of EU food legislation that should be taken into account before placing such products on the market, as well as of the voluntary labeling of functional, nutritional and sustainability benefits important for consumers

PHARMACOGENETICS AND INTERACTIONS OF ANTIDEPRESSANTS IN THE TREATMENT OF CO-MORBID ILLNESS

Patients who require long-term treatment for depression have an increased risk of experiencing drug interactions since they will take medications for and/or co-morbid illness. Antidepressants can be the object of drug interactions by other substances, or they can precipitate interactions by inhibiting enzyme pathways. There is an increasing agreement about the importance of polymorphisms in cytochrome P450 enzymes and the effects of drug-drug interactions in relation to the incidence of adverse effects. Genetic test suitable for the routine laboratory are now available for some important metabolizing enzymes (e.g. CY2D6, CY2C19) identifying those individuals who are slow or fast metabolizers of certain drugs. Specific antidepressants differ in the interactions with CYP450 isoenzymes and in their susceptibility to drug-drug interactions. The main focus of this article is pharmacokinetic drug interactions of antidepressants. With that specific knowledge, clinicians can improve outcomes of depressed patients, by considering the possibility of drug interactions both before prescribing a specific antidepressant and while monitoring for response, adverse effects and patient compliance

Clinical characteristics of multiple system atrophy in Serbian population

Background/Aim. Mulstiple system atrophy (MSA) is a neurodegenerative central nervous system disorder, characterized by any combination of extrapyramidal, cerebellar, pyramidal or autonomic disturbance. The aims of our study were to define clinical characteristics of MSA patients in our population, to account for neuroradiological and electrophysiological profile of the disease and to evaluate one-dose levodopa response. Methods. We have diagnosed 29 patients as MSA, with disease duration from the first symptom 5 years on average on examination. The examinating procedure included an anamnesis and complete neurological investigations, as well as neurootological and neuroradiological examinations. The study included the patients of the Institute of Neurology of the Clinical Center of Serbia in the period of 1996-2001, who completed both clinical and diagnostic criteria for a possible and probable MSA. Results. Autonomic disturbances were documented in 93.1%, whereas extrapyramidal symptoms were seen in additional 89.3% with symmetrical onset in 60%. Levodopa response was poor or moderate. Cerebellar signs were present in 63%, while pyramidal signs occured in 78.7%. There was no a cognitive deterioration (MMSE &gt; 24). CT scan and MRI showed cerebellar and brainstem atrophy, as well as diffuse cortical atrophy. Conclusion. Failure of additional diagnostic procedures to distinguish MSA patients required a precise understanding of their clinical specificities. Our results support this statement

Effects of vortioxetine in animal model of migraine

Увод: Мигрена је препозната као један од водећих здравствених проблема на глобалном нивоу, јер је праћена онеспособљеношћу и нарушеним квалитетом живота оболелих. Преко 50% пацијената са мигреном није задовољно својим лечењем. Постоје докази о ефикасности антидепресива, посебно оних са мултимодалним дејством (амитриптилин), и препоруке за њихову примену у профилакси мигренозне главобоље. Вортиоксетин је нови мултимодални антидепресив са недавно постулираним аналгетским својствима. Циљ рада: 1) Испитати аналгетску ефикасност вортиоксетина у поређењу са суматриптаном након пероралне акутне примене у моделу акутне мигренозне главобоље; 2) Испитати аналгетску ефикасност вортиоксетина у поређењу са пропранололом након поновљене профилактичке пероралне примене у моделу хроничне мигрене. Материјал и методе: Модел акутне мигренозне главобоље постављен је акутном применом нитроглицерина (10 mg/kg, интраперитонеално), док је модел хроничне мигрене постављен поновљеном, интермитентном применом нитроглицерина, сваког другог дана у деветодневним циклусима код мужјака мишева C57BL/6 соја. Поновљена примена нитроглицерина доводи до развоја хроничне базалне и акутне болне преосетљивости. За процену развоја болне преосетљивости, као и антиноцицептивног дејства испитиваних третмана, коришћени су тестови провоцираног болног понашања (von Frey тест – механички стимулус и орофацијални глутаматни тест – хемијски стимулус), као и тест непровоцираног болног понашања (тест копања), који је уједно одраз опште добробити животиња. Добијени резултати анализирани су применом једнофакторске/двофакторске ANOVA-е (уз Tukey post hoc анализу). Резултати: У моделу акутне мигренозне главобоље забележен је статистички значајан, упоредив (von Frey тест) или већи (орофацијални глутаматни тест) антиноцицептивни ефекат вортиоксетина у односу на суматриптан. У моделу хроничне мигрене показан је статистички значајан, упоредив (von Frey тест – базална преосетљивост, орофацијални глутаматни тест и тест копања) или већи (von Frey тест – акутна преосетљивост) антиноцицептивни ефекат вортиоксетина у односу на пропранолол. Закључак: Приказани резултати указују да је вортиоксетин је барем поредбено ефикасан као и референтни лекови за контролу мигренозних атака/профилаксу мигрене, што је налаз од могућег клиничког значаја.Introduction: Мigraine is recognized as a global health issue, responsible for high population levels of disability and impaired well-being. Above 50% of migraine sufferers are not satisfied with their pain relief strategies. There is evidence of antidepressants’ efficacy, especially those with multimodal action (amitriptyline), and recommendations for their use in migraine prophylaxis. Vortioxetine is a novel multimodal antidepressant with recently postulated analgesic properties. The Aim: 1) To examine the efficacy of vortioxetine compared to sumatriptan after acute oral administration in a migraine attack model; and 2) to examine the efficacy of vortioxetine compared to propranolol after repeated prophylactic oral administration in a chronic migraine model. Material and Methods: The model of a migraine attack was established by acute nitroglycerin injection (10 mg/kg, intraperitoneally), whereas the model of chronic migraine was developed by repeated, intermittent administration of nitroglycerin, every other day, over 9 days in male mice, C57BL/6 strain. Repeated nitroglycerin administration causes chronic basal and acute hypersensitivity. To assess the development of painful hypersensitivity, and the antinociceptive effects of corresponding treatments, stimulus-evoked tests (von Frey test – mechanical stimulus; orofacial glutamate test – chemical stimulus), and non-evoked nociceptive test (burrowing test; also reflecting general animal welfare) were used. The results were analyzed by one-way/two-way ANOVA (Tukey post hoc analysis). Results: In the migraine attack model, statistically significant, comparable (von Frey test) or higher (orofacial glutamate test) antinociceptive effects of vortioxetine compared to sumatriptan was observed. In the chronic migraine model, vortioxetine showed statistically significant, comparable (von Frey test – basal hypersensitivity, orofacial glutamate and burrowing tests) or higher (von Frey test – acute hypersensitivity) antinociceptive effects compared to propranolol. Conclusion: The presented results imply that vortioxetine is at least comparably effective as selected referent drugs for migraine attack/migraine prophylaxis treatment, giving clinical importance to our findings