4 research outputs found
Procena simptoma i znakova oralnih mekotkivnih poremeÄaja kod hospitalizovanih bolesnika sa shizofrenijom
Introduction Patients with schizophrenia are likely to constitute a high-risk group of individuals with respect to prevalence of oral diseases and they require special attention. Factors like nature of psychiatric disorders, length of stay and oral-side effects of psychotropic medications have been noted as contributors to poor oral health among institutionalized chronic psychiatric patients. Methods This cross-sectional study comprised 190 inpatients with schizophrenia at the Dr Laza Lazarevic Clinic for Mental Disorders in Belgrade, and 190 mentally healthy patients at the Clinic for Periodontology and Oral Medicine, School of Dental Medicine, University of Belgrade. A questionnaire was designed for the purpose of this research with the aim of recording information on demographic data (age and sex), unhealthy habits (tobacco smoking, alcohol consumption and drug abuse), and data about the existence of any oral symptom and/or sings related to oral soft tissue pathology. All participants were subjected to targeted clinical examinations. Results All study group patients were receiving psychotropic medications (mean number 4.18 Ā± 1.14; from 1 to 7 medications). The study group patients had a total of 272 symptoms and 121 signs of oral disorders; which was almost four times higher for symptoms and even nine times higher for signs of oral disorders than in the control group. Conclusion Schizophrenia as a mental disorder does not directly affect the condition of oral health of this group of psychiatric patients, but indirectly - reducing their motivation and awareness of the importance of oral health, which is particularly emphasized in hospital conditions.Uvod Hospitalizovani bolesnici sa shizofrenijom mogu da predstavljaju visoko riziÄnu grupu osoba sa aspekta prevalencije oralnih oboljenja, te zahtevaju posebnu pažnju. Faktori poput prirode psihijatrijske bolesti, dužine hospitalizacije i neželjenih efekata psihotropnih medikamenata utiÄu na loÅ”e oralno zdravlje hospitalizovanih hroniÄnih psihijatrijskih bolesnika. Metode Ova studija preseka obuhvatila je 190 bolesnika sa shizofrenijom hospitalizovanih u Klinici za psihijatrijske bolesti "Dr Laza LazareviÄ" u Beogradu i 190 mentalno zdravih bolesnika Klinike za paradontologiju i oralnu medicinu StomatoloÅ”kog fakulteta Univerziteta u Beogradu. U svrhu ovog istraživanja dizajniran je upitnik sa ciljem beleženja demografskih podataka (starost i pol), loÅ”ih navika (puÅ”enje duvana, konzumiranje alkohola i zloupotreba droga) i podataka o postojanju bilo kojeg oralnog simptoma i/ili znaka koji se odnosi na patologiju mekih tkiva usne duplje. Svi uÄesnici bili su podvrgnuti ciljanim kliniÄkim pregledima. Rezultati Svi bolesnici iz studijske grupe primali su psihotropne lekove (srednja vrednost 4,18 Ā± 1,14, od jednog do sedam lekova). Bolesnici studijske grupe imali su ukupno 272 oralna simptoma i 121 znak oralnih oboljenja, Å”to je skoro Äetiri puta viÅ”e za oralne simptome, a Äak i devet puta viÅ”e za znake oralnih poremeÄaja nego u kontrolnoj grupi. ZakljuÄak Shizofrenija kao mentalni poremeÄaj ne utiÄe direktno na stanje oralnog zdravlja ove grupe psihijatrijskih bolesnika, veÄ indirektno - smanjujuÄi im motivaciju i svest o znaÄaju oralnog zdravlja, posebno u bolniÄkim uslovima
The characteristics of the patients with Rett syndrome: Case series
Rett syndrome is a neurodevelopmental disorder caused by mutation in the gene MECP2 on the X chromosome. The main clinical characteristics are breathing disorders, epileptic seizures, scoliosis, walking disability and constipation with frequent growth failure and malnutrition. Our transversal study included 29 female patients with Rett syndrome treated in the Institute for Mother and Child Health Care ''Dr Vukan ÄupiÄ'' in Belgrade. The patients were anthropometrically measured by their height and weight and caluculating body mass index. The degree of scolisios, the frequency of epileptic seizures, walking ability and grade of respiratory dysfunction were assessed based on the clinical scales for disease severity estimation. The statistical data analysis was done in the software package PASW Statistics 18. The average age of the patients was 145.5Ā±90.1 months. The average height was 125.2Ā±22.1cm, the average weight 27.6Ā±12.3kg, and the average body mass index was 16.6Ā±3.5kg/m2. The average z scores for height, weight and BMI-for-age were statistically significantly lower in comparison to general population, which is given with negative z scores. There was the statistically significant negative coorelation between the age of patients and the average z scores for height-for-age (r=-0.464 p=0.011), weight-for-age (r=-0.433 p=0.019) and BMI-for-age (r=-0.433 p=0.019). The statistically significant negative coorelation was found between the degree of scoliosis and the average z scores for height and weight-for-age, but not with the average z score for BMI-for-age. The growth failure and malnutrition represent significant problems which are found in Rett syndrome. The detection of factors affecting the growth and nutrition in patients with Rett syndrome could greatly contribute to the improvement of the quality of life in the patients with Rett syndrome and perhaps lead to the correction of the approach of symptomatic and supportive therapy
The importance of early recognition and timely treatment of delirium in intensive care units
Delirium is connected to bad short-term (the increase in hospital mortality rate and hospital days) and long-term outcomes (disfunctionality, institutionalisation, cognitive damage and post hospital-release dementia). The objective of this study is to determine whether there are possible incompatibilities of treatment of delirium with the recommendations in the guides of good clinical practice from developed countries. The grounded method was used in the study. The so called principal sampling of 17 psychiatrists, anesthesiologists and registered nurses was conducted. Afterwards, the unstructured interviews with the selectees were conducted, transcribed and analyzed immediately through coding, category and concept detection. Having completed this, the theoretical sampling of new interview examinees was conducted. Their analysis enabled the concepts to be linked into a working theory and graphically displayed. The new sampling, the new interviews and their analysis were then continued interactively until the saturation of the working theory was achieved and the final version of the theory was formulated based on the findings reached through the interviews. Having completed the principal sampling and coding of the transcripts led the researches to the saturation of the theory through the separation of eight categories: A - Delirium as a sign of system infection, B - Therapy - Anaesthesiologists administer benzodiazepines, whereas psychiatrists administer antipsychotics, C - An inconspicuous onset of delirium is overlooked, D - Bleeding as the cause of delirium, E -Anticholinergics as a cause of delirium, F - Misunderstanding the nature of delirium by anaesthesiologists, G -Being aware that the patient is vitally endangered, and H - The nurses apply enhanced health care measures. Delirium is a syndrome which can be prevented in 30 -40% of cases (50). An etiological treatment would help avoid complicating delirium's clinical picture and would very much prevent poor outcomes, such as institutionalisation, cognitive damage and delirious patients' high mortality rate