Vascular access failure-cause or complication of central venous catheterization: Case report

© 2020, University of Kragujevac, Faculty of Science. All rights reserved. The quality of life and patient survival rate in terminal chronic renal insufficiency depends on the duration of vascular approaches. Dialysis catheters are used to establish an adequate vascular approach when emergency hemodialysis is indicated and when all approaches are exhausted. Complications of CVC can be classified into three categories: mechanical (hematoma, arterial puncture, pneumothorax, hemothorax, catheter misplacement, and stenosis), infectious (insertion site infection, CVC colonization, and bloodstream infection) and thrombotic (deep vein thrombosis). Despite the increasing prevalence of haemodialysis patients with complex access issues, there remains no consensus on the definition of vascular access failure or end-stage vascular access. The dilema in these cases remains whether the generalized vascular insufficiency is the cause or a complication of exhausted vascular accesses. This case report is one of the examples of combined complications with generalized vascular access insufficiency. During the year and a half of the chronic dialysis program, the patient had several changes of vascular approaches, and each approach became dysfunctional in certain time due to various causes. After six months of successful hemodialysis, the patient was admitted with signs of infection and during hospitalization was again subjected to multiple changes of the vascular approach due to infection, thrombosis, and vascular access failure

Depression, anxiety and stress among alcohol addicts

Objective. The aim of the study was to examine the level of depression, anxiety and stress in alcohol addicts, i.e. to determine differences in the level of depression, anxiety and stress between the group of subjects diagnosed with F10.1 and the group of subjects diagnosed with F10.2, as well as to determine differences in sociodemographic characteristics and health status between the groups of subjects diagnosed with F10.1 and F10.2. Methods. Our study was designed as a non-experimental, observational cross-sectional study. It was conducted at the University Clinical Centre Kragujevac in the Clinic for Psychiatry, during January 2021. The sample consisted of 110 respondents of both sexes, aged 18 to 65, divided into two groups. The first group consisted of subjects diagnosed with alcohol dependence (F10.2), and the second group consisted of subjects diagnosed with alcohol abuse (F10.1). Results. Our study has shown that alcohol addicts have clinically significant and severe symptoms of depression, that symptoms were positively correlated with stress levels, and that short-term stress of milder intensity was associated with occasional alcohol abuse, while prolonged stress was a predictor of alcohol dependence. No statistically significant association of alcohol dependence and alcohol abuse with anxiety was found. It was also found that alcohol dependence is associated with certain sociodemographic characteristics such as gender and marital status, education level, employment status, as well as health status and the number of hospitalizations.Conclusion. With this study, we have shown how much stress is present and important in the genesis of alcoholism, as well as the positive correlation of depression and alcohol dependence, and the importance of sociodemographic characteristics in their genesisPublishe

Attitudes of Primary School Teachers Toward Inclusive Education

Background: The aims of our study are related to examining the relevance of teachers' attitudes toward the implementation of inclusive education. In addition, its subject is related to the implications on inclusive education policies, limitations of the existing study along with the recommendations for our future research endeavors. Methods: The research is a cross-sectional study type. The sample included 64 primary school teachers in the lower grades of primary school (grades 1–4), selected by using simple random sampling, in three primary schools on the territory of Belgrade, Serbia in 2021 (26, 17, and 21 primary school teachers). The Questionnaire for Teachers, which was used as a research instrument, was taken from the Master's Thesis Studen Rajke, which was part of the project “Education for the Knowledge Society” at the Institute for Educational Research in Belgrade. Dependent variables measured in the study referred to the attitudes of primary school teachers toward inclusive education. Categorical variables are represented as frequencies and the Chi-square test was used to determine if a distribution of observed frequencies differed from the expected frequencies. Results: One in three teachers (32.8%) thought that inclusion was useful for children with disabilities (29.7%), of them thought that schools did not have the conditions for inclusive education, whereas one in four teachers (25.0%) believed that inclusion was not good. No statistically significant differences were found in the attitudes of professors, when observed in terms of their gender, age and length of service. Conclusion: Investing more resources and time in developing and implementing special education policies can promote successful inclusive education

Psychological and sociodemographic characteristics and development of physical exercise dependence

© 2018, Revista Brasileira de Medicina do Esporte. All rights reserved. Introduction: Excessive physical exercise combined with certain psychic and sociodemographic factors can lead to dependence. Objective: To examine which factors lead to the emergence of exercise dependence. Methods: Sample consisted of 103 men (mean age 27.3 years, SD 6.127) who performed exercises at gyms at least three times a week in the last year or more in Novi Pazar, Sjenica, Raska and Tutin, Serbia. Participants completed questionnaires and took appropriate tests. Results: Our results showed that there is no association between exercise dependence and financial status, number of siblings, level of education, family stability, health, and medication use among the interviewees. However, it was found that the degree of exercise dependence is associated with marital status and problems with the law. Regression analysis showed that body dysmorphia, body mass index and aggressiveness are better predictors of exercise dependence. Conclusion: People whose self-perception is dismorphic have lower self-esteem, and exercise in gyms to improve their physical appearance. If we consider other characteristics, such as unfavorable BMI, problems with the law and being single, it is hardly surprising these individuals cross the line between healthy exercise and exercise dependence. An important finding is that aggressiveness and exercise dependence are related to problems with the law due to aggression, and body dysmorphia. Level of Evidence; Diagnostic studies - Investigating a diagnostic test

Cigarette smoking and heavy coffee drinking affect therapeutic response to olanzapine

© 2018, Serbia Medical Society. All rights reserved. Introduction/Objective Considering relatively complex pharmacokinetic profile of olanzapine, it is expected that certain medications and some compounds, found in food and drink, can induce or inhibit its metabolism. The aim of our study was to investigate the influence of cigarette smoking and heavy coffee consumption on the clinical response to olanzapine. Methods The phase IV, open-labeled, four-week-long prospective clinical trial included 108 adult patients diagnosed with schizophrenia. According to cigarette smoking (n = 52) and coffee drinking (n = 55), four subgroups were defined: non-smokers, non-heavy coffee consumers (group 1), non-smokers, heavy coffee consumers (group 2), smokers, non-heavy coffee consumers (group 3) and smokers and heavy coffee consumers (group 4). Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) scales were used for therapeutic response evaluation. Results Baseline and final GAF scores were 33.3 ± 5.0 and 61.5 ± 9.6, respectively, and PANSS scores were 100.7 ± 3.9 and 85.5 ± 5.4, respectively. The changes of GAF and PANSS scores from the baseline to the study end were 115.1 ± 35.7 and -19.6 ± 3.1, respectively (group 1), 91.1 ± 30.8 and -15.3 ± 2.9, respectively (group 2), 76.1 ± 29.8 and -13.4 ± 4.4, respectively (group 3), and 64.7 ± 29.3 and -11.3 ± 3.22, respectively (group 4), making significant subgroup differences for both scale scores (p < 0.001). Cigarette smoking and heavy coffee drinking significantly and independently diminished improvement in both GAF and PANSS total score (p < 0.001). Changes of body mass index from the baseline significantly influenced the change of PANSS total score only (p = n.s.), in a negative direction (r = -0.454, p < 0.001). Conclusion Smoking and heavy coffee drinking influenced effects of olanzapine in patients with schizophrenia treated in routine practice

Cigarette smoking and heavy coffee drinking affect therapeutic response to olanzapine

© 2018, Serbia Medical Society. All rights reserved. Introduction/Objective Considering relatively complex pharmacokinetic profile of olanzapine, it is expected that certain medications and some compounds, found in food and drink, can induce or inhibit its metabolism. The aim of our study was to investigate the influence of cigarette smoking and heavy coffee consumption on the clinical response to olanzapine. Methods The phase IV, open-labeled, four-week-long prospective clinical trial included 108 adult patients diagnosed with schizophrenia. According to cigarette smoking (n = 52) and coffee drinking (n = 55), four subgroups were defined: non-smokers, non-heavy coffee consumers (group 1), non-smokers, heavy coffee consumers (group 2), smokers, non-heavy coffee consumers (group 3) and smokers and heavy coffee consumers (group 4). Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) scales were used for therapeutic response evaluation. Results Baseline and final GAF scores were 33.3 ± 5.0 and 61.5 ± 9.6, respectively, and PANSS scores were 100.7 ± 3.9 and 85.5 ± 5.4, respectively. The changes of GAF and PANSS scores from the baseline to the study end were 115.1 ± 35.7 and -19.6 ± 3.1, respectively (group 1), 91.1 ± 30.8 and -15.3 ± 2.9, respectively (group 2), 76.1 ± 29.8 and -13.4 ± 4.4, respectively (group 3), and 64.7 ± 29.3 and -11.3 ± 3.22, respectively (group 4), making significant subgroup differences for both scale scores (p < 0.001). Cigarette smoking and heavy coffee drinking significantly and independently diminished improvement in both GAF and PANSS total score (p < 0.001). Changes of body mass index from the baseline significantly influenced the change of PANSS total score only (p = n.s.), in a negative direction (r = -0.454, p < 0.001). Conclusion Smoking and heavy coffee drinking influenced effects of olanzapine in patients with schizophrenia treated in routine practice

Quality of Life in Primary Insomnia: Three-week Treatment With Zolpidem Vs. Lorazepam

Insomnia is a condition of inadequate quality or quantity of sleep that has extremely adverse effects on daytime activities. Th e aim of this study was to compare the quality of life in patients with primary insomnia before and after a 3-week treatment with lorazepam (n=20) and zolpidem (n=21) and to compare the potential differences in dysfunctional beliefs and attitudes regarding patients’ sleep between the two groups. Th e diagnosis of primary insomnia was established using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and patients had to complete a specially designed sleep log every day; on scheduled visits, we also administered a Visual Analogue Scale for quality of life and a self-evaluation questionnaire about Dysfunctional Beliefs and Attitudes related to Sleep at the beginning and end of this study. In summary, the examinees in our study had significantly decreased parameters of quality of life, quite lower than expected based on previous findings in this area. However, by the end of the study, quality of life significantly improved with treatment: it improved by approximately 2/3 in the Lorazepam group and more than twice in the Zolpidem group, with a significant difference in favour of Zolpidem (p=0.047). Th is finding is most likely a consequence of its better safety profile and in part its better efficiency in terms of influence on certain domains of sleep itself, as previously discussed. Further specialized studies in this area with larger samples and a more detailed methodology are clearly warranted

Quality of life in primary insomnia: Three-week treatment with zolpidem vs. lorazepam

© 2017, University of Kragujevac, Faculty of Science. All rights reserved. Insomnia is a condition of inadequate quality or quantity of sleep that has extremely adverse effects on daytime activities. The aim of this study was to compare the quality of life in patients with primary insomnia before and after a 3-week treatment with lorazepam (n=20) and zolpidem (n=21) and to compare the potential differences in dysfunctional beliefs and attitudes regarding patients’ sleep between the two groups. The diagnosis of primary insomnia was established using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria, and patients had to complete a specially designed sleep log every day; on scheduled visits, we also administered a Visual Analogue Scale for quality of life and a self-evaluation questionnaire about Dysfunctional Beliefs and Attitudes related to Sleep at the beginning and end of this study. In summary, the examinees in our study had significantly decreased parameters of quality of life, quite lower than expected based on previous findings in this area. However, by the end of the study, quality of life significantly improved with treatment: it improved by approximately 2/3 in the Lorazepam group and more than twice in the Zolpidem group, with a signifi cant difference in favour of Zolpidem (p=0.047). This finding is most likely a consequence of its better safety profile and in part its better efficiency in terms of influence on certain domains of sleep itself, as previously discussed. Further specialized studies in this area with larger samples and a more detailed methodology are clearly warranted

Influence of antipsychotics on metabolic syndrome risk in patients with schizophrenia

Objective: Many studies so far have shown that antipsychotic therapy may have an effect on the development of metabolic syndrome in patients diagnosed with schizophrenia. Our goal was to determine whether our respondents are at risk for developing metabolic syndrome and who is more predisposed to it. Methods: In a stable phase, 60 patients diagnosed with schizophrenia were equally divided into three groups according to the drug (risperidone, clozapine, and aripiprazole monotherapy). Control group had 20 healthy examinees. Patients were evaluated first using The Positive and Negative Syndrome Scale (PANSS). Prolactin, lipid status, glycemia, insulin, cytokine values (IL-33, TGF-β, and TNF-α) and C-reactive protein (CRP) were measured. Also, Body mass index (BMI), Homeostatic Model Assesment for Insulin Resistance (HOMA index), waist and hip circumference (WHR) and blood pressure (TA) measurement were performed in the study. Results: Patients treated with risperidone compared to healthy control subjects and aripiprazol group of patients had statistically significant difference in prolactin levels. In clozapine group compared to healthy control group values of HDL cholesterol and glucose level were statistically significant different. In aripiprazole group compared to healthy control group value of BMI was statistically significant different. Statistically significant correlations were found in TNF-α with glucose and HOMA index in risperidone treated patients and with BMI in clozapine group of patients; IL-33 with glucose in risperidone and with BMI in clozapine group of patients and TGF-β with glucose in risperidone group, with insulin and HOMA index in clozapine group and statistically significant negative correlation with LDL cholesterol in aripiprazole group of patients. Conclusion: Patients on risperidone and clozapine therapy may be at greater risk of developing metabolic syndrome than patients treated with aripiprazole. Statistically significant difference in concentration of TNF-α and TGF-β was in the group of patients treated with risperidone compared to healthy control group