Kvalitet života povezan sa zdravstvenim stanjem studenata medicine - komparativna studija

Background/Aim. Previous studies on medical students' subjective perception of health and health-related quality of life (HRQoL) showed inconclusive results. Moreover, there are no published studies to compare HRQoL of medical students to non-medical university students. The aim of the study was to assess subjective perception of health-related quality of life (HRQoL) in medical students' sample, to compare it with non-medical university stu-dents and to ascertain predictors of better perception of HRQoL in medical students. Methods. Scores of all domains on the Mental and Physical Component Summary subscales and total score of the Short Form Health Survey (SF-36), used for assessment of HRQoL in samples of 561 medical and 332 non-medical university students were assessed and compared. In addition, linear regression to identify predictors of better perception of mental and physical components of HRQoL and overall HRQoL in the sample of medical students was used. The dependant variables were subscores and total score with the SF- 36, and independent variables were certain sociodemographic and academic characteristics of the students. Results. Medical students had statistically significantly higher scores on the Mental Component Summary and total SF-36 score compared to non-medical students. Linear regression analysis demonstrated that higher scores of Physical Component Summary were associated with age, male sex and the year of studies. The Mental Component Summary were associated with age, male sex, the year of studies and marital status. The total SF-36 score was associated with age, male sex and the year of studies. Conclusion. Medical students perceive their health much better than other university students do, but female, older and second grade medical students have worse perception of their HRQoL. Those points should be potential target areas for specific prevention and treatment in order to achieve better HRQoL.Uvod/Cilj. Dosadašnje studije subjektivne percepcije zdravlja i kvaliteta života povezanog sa zdravstvenim stanjem (HRQoL) studenata medicine pokazale su kontradiktorne rezultate. Štaviše, ne postoje objavljene studije koje su poredile HRQoL studenata medicine i studenata ne- medicinskih fakulteta. Cilj ove studije bio je da se proceni subjektivna percepcija HRQoL na uzorku studenata medicine, da se uporedi sa percepcijom HRQoL studenata ne- medicinskih fakulteta i da se utvrde prediktori bolje percepcije HRQoL kod studenata medicine. Metode. Uzorak za istraživanje obuhvatio je 561 studenta medicine i 332 studenta ne-medicinskih fakulteta Univerziteta u Beogradu. Istraživanje je obavljeno uz pomoć Short Form Health Survey (SF-36) upitnika koji procenjuje mentalnu i fizičku komponentu, kao i ukupan skor subjektivne procene kvaliteta života vezanog za zdravstveno stanje. Upoređeni su skorovi sa zbirne skale i supskala dve grupe studenata. Pored toga, korišćena je i linearna regresija da bi se procenili prediktori boljeg sagledavanja ukupnog skora i mentalne i fizičke komponente HRQoL na uzorku studenata medicine. Zavisne varijable bile su supskorovi i ukupan skor sa SF- 36 upitnika, a nezavisne varijable sociodemografske i akademske karakteristike ispitanika. Rezultati. Studenti medicine imali su statistički značajno više skorove na supskali mentalnog zdravlja i na ukupnom skoru SF-36 upitnika u odnosu na studente ne-medicinskih fakulteta. Linearna regresija pokazala je da su viši skorovi fizičke komponente povezani sa godinama starosti, muškim polom i godinom studija; viši skorovi mentalne komponente povezani sa godinama starosti, muškim polom, godinom studija i bračnim statusom. Ukupan SF-36 skor povezan je sa godinama starosti, muškim polom i godinom studija. Zaključak. Studenti medicine gledaju na svoje zdravstveno stanje mnogo bolje nego studenti ne-medicinskih fakulteta. Ipak, devojke, stariji studenti i studenti druge godine medicine imaju lošiju percepciju svog kvaliteta života koji se vezuje za zdravlje. Ovo bi trebalo da budu fokusi za specifičnu prevenciju i eventualnu terapiju u cilju postizanja boljeg kvaliteta života studenata medicine

8-Iso-prostaglandin F2α as a potential biomarker in patients with unipolar and bipolar depression

Objective: Previous studies have shown that the disturbance of redox homeostasis plays a role in the pathogenesis of mood disorders. It is currently unclear whether oxidative stress parameters can be used as biomarkers (state vs. trait). The aim of the present study was to investigate oxidative stress markers in patients with major depressive disorder (MDD) and bipolar disorder (BP) in acute depressive episodes and remission, and healthy individuals. Patients and methods: Thirty-two patients with a diagnosis of MDD, 32 patients with a diagnosis of BP and 32 matched healthy controls were included in the study. We measured the serum levels of markers of oxidative damage, including 8-hydroxy-2'-deoxyguanosine (8-OHdG), 8-Iso-prostaglandin F2α (8-iso-PGF2α; 8-isoprostane), and malondialdehyde (MDA), and also serum activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX), and glutathione reductase (GR) in both acute and remission phase, and in control group. Results: After controlling for the effects of age, sex, body mass index, and smoking status, serum 8-iso-PGF2α levels were significantly higher in both patient groups compared to controls, regardless of disease phase. The activities of GPX and GR were significantly lower in the acute phase in MDD patients compared to controls. Serum GR activity was lower in both acute and remission phase in MDD compared to BP. Conclusions: Our results suggest that both MDD and BP are associated with a disturbed redox balance with a particularly pronounced increase in serum 8-iso-PGF2α levels in both groups and the presence of glutathione metabolism disorders in MDD patients. Further research is needed to confirm the importance of oxidative stress parameters as potential biomarkers of MDD and BP

Uloga krvno-moždane barijere u psihijatrijskim oboljenjima

The blood-brain barrier (BBB) is formed by continuous, closely connected endothelial cells, enveloped in the basal lamina, pericytes, and foot extensions of astrocytes. BBB has a vital role in brain metabolism and protects the brain parenchyma from harmful agents present in the systemic circulation. Damage to the BBB and an increase in its permeability have an important role in many neurodegenerative diseases. This paper aims to review the literature on the impact of the BBB damage on psychiatric illness, a largely neglected and under researched area. Links between BBB impairment and specific neuropsychiatric disorders are described including schizophrenia, affective disorders, dementias with behavioral disorders, and alcohol use disorder, with comparison to typical hereditary small vessel diseases affecting the BBB such as cerebral autosomal dominant arteriopathy with subcortical infarction and leukoencephalopathy (CADASIL) and mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS). The authors critically summarize possible pathogenic mechanisms linking BBB damage and these common disorders.Крвно-мождана баријера (КМБ) се састоји од континураних, тесно спојених ендотелних ћелија омотаних базалном ламином, перицитима и сто-паластим продужецима астроцита. КМБ има виталну функцију и можданом метаболизму и штити мождани паренхим од штетних фактора присутних у системској циркулацији. Показано је да оштећење КМБ и повећање њене пропустљи-вости има значајну улогу у многим неуродегене-ративним обољењима. Циљ овога рада је преглед литературе о значају оштећења КМБ код психијатријских обољења, до сада занемареној и недовољно истраженој облас-ти. Повезаност измедју поремећаја КМБ и неуро-психијатријских поремећаја је посебно анализи-рана за схизофренију, афективне поремећаје, де-менције са бихевиоралним изменама, поремећај употребе алкохола, са посебним освртом на на-следне болести малих крвних судова мозга са оштећењем КМБ као што су церебрална аутозо-мално доминантна артериопатија са супкортика-ним инфарктима и леукоенцефалопатијом (CADASIL) и митохондријска енцефаломиопатија са лактатном ацидозом и епизодама налик можда-ном удару (MELAS). Аутори критички сумирају могуће патогенетске механизме који повезују оштећења КМБ са овим честим обољењима

Effects of Vitamin D3 on the NADPH Oxidase and Matrix Metalloproteinase 9 in an Animal Model of Global Cerebral Ischemia.

Decreased blood flow in the brain leads to a rapid increase in reactive oxygen species (ROS). NADPH oxidase (NOX) is an enzyme family that has the physiological function to produce ROS. NOX2 and NOX4 overexpression is associated with aggravated ischemic injury, while NOX2/4-deficient mice had reduced stroke size. Dysregulation of matrix metalloproteinases (MMPs) contributes to tissue damage. The active form of vitamin D3 expresses neuroprotective, immunomodulatory, and anti-inflammatory effects in the CNS. The present study examines the effects of the vitamin D3 pretreatment on the oxidative stress parameters and the expression of NOX subunits, MMP9, microglial marker Iba1, and vitamin D receptor (VDR), in the cortex and hippocampus of Mongolian gerbils subjected to ten minutes of global cerebral ischemia, followed by 24 hours of reperfusion. The ischemia/reperfusion procedure has induced oxidative stress, changes in the expression of NOX2 subunits and MMP9 in the brain, and increased MMP9 activity in the serum of experimental animals. Pretreatment with vitamin D3 was especially effective on NOX2 subunits, MMP9, and the level of malondialdehyde and superoxide anion. These results outline the significance of the NOX and MMP9 investigation in brain ischemia and the importance of adequate vitamin D supplementation in ameliorating the injury caused by I/R

The effects of long-term antipsychotic application on redox regulation in the animal model of schizophrenia

Shizofrenija je hronični psihotični poremećaj sa karakteristikama dezorganizacije većine psihičkih funkcija koji se javlja u oko 1% opšte populacije...Schizophrenia is a chronic psychotic disorder with characteristics of the disorganization of most mental functions that affects about 1% of the general population..

The effects of long-term antipsychotic application on redox regulation in the animal model of schizophrenia

Shizofrenija je hronični psihotični poremećaj sa karakteristikama dezorganizacije većine psihičkih funkcija koji se javlja u oko 1% opšte populacije...Schizophrenia is a chronic psychotic disorder with characteristics of the disorganization of most mental functions that affects about 1% of the general population..

How do we treat generalized anxiety disorder?

Introduction. In addition to significant prevalence of generalized anxiety disorder (GAD) and related consequences, it seems that this disorder has not been studied sufficiently in Serbia. Objective. The aim of this study was to investigate the understanding of psychopathology and the adequate treatment of patients with GAD by psychiatrists in Serbia. Methods. The study comprised 84 doctors - psychiatrists and neuropsychiatrists who were engaged in treatment of patients with GAD. Anonymous survey was used as the basic instrument, which collected information about the socio-demographic and professional data, experience in treating GAD and understanding psychopathology of GAD, as well as the first and the second choice therapy for patients with GAD. Results. The majority of psychiatrists (62.2%) indicated the symptoms of distress/tension and slightly lower percent (36.6%) designated the symptoms of worry/anxiety as the key symptoms of GAD when it was diagnosed. The results showed that almost all patients (96.5%) had been treated with benzodiazepines before coming to psychiatrists. Most psychiatrists preferred the use of SSRI/SNRI antidepressants (76.2%), usually in combination with benzodiazepines (71.4%) for the treatment of patients with GAD; however, if these doctors got GAD, the preference of benzodiazepine use would be significantly lesser (45.2%) than for the treatment of their patients. Preference for the use of SSRI/SNRI antidepressants was significantly more frequent in physicians with completed residency. Conclusion. The understanding of psychopathology and treatment practice for patients with GAD in this sample of psychiatrists in Serbia is mostly consistent with the current trends for GAD treatment

Medical students` health-related quality of life - a comparative study

Background/Aim. Previous studies on medical students’ subjective perception of health and health-related quality of life (HRQoL) showed inconclusive results. Moreover, there are no published studies to compare HRQoL of medical students to non-medical university students. The aim of the study was to assess subjective perception of health-related quality of life (HRQoL) in medical students’ sample, to compare it with non-medical university stu-dents and to ascertain predictors of better perception of HRQoL in medical students. Methods. Scores of all domains on the Mental and Physical Component Summary subscales and total score of the Short Form Health Survey (SF-36), used for assessment of HRQoL in samples of 561 medical and 332 non-medical university students were assessed and compared. In addition, linear regression to identify predictors of better perception of mental and physical components of HRQoL and overall HRQoL in the sample of medical students was used. The dependant variables were subscores and total score with the SF- 36, and independent variables were certain sociodemographic and academic characteristics of the students. Results. Medical students had statistically significantly higher scores on the Mental Component Summary and total SF-36 score compared to non-medical students. Linear regression analysis demonstrated that higher scores of Physical Component Summary were associated with age, male sex and the year of studies. The Mental Component Summary were associated with age, male sex, the year of studies and marital status. The total SF-36 score was associated with age, male sex and the year of studies. Conclusion. Medical students perceive their health much better than other university students do, but female, older and second grade medical students have worse perception of their HRQoL. Those points should be potential target areas for specific prevention and treatment in order to achieve better HRQoL

Medical students` health-related quality of life - a comparative study

Background/Aim. Previous studies on medical students' subjective perception of health and health-related quality of life (HRQoL) showed inconclusive results. Moreover, there are no published studies to compare HRQoL of medical students to non-medical university students. The aim of the study was to assess subjective perception of health-related quality of life (HRQoL) in medical students' sample, to compare it with non-medical university stu-dents and to ascertain predictors of better perception of HRQoL in medical students. Methods. Scores of all domains on the Mental and Physical Component Summary subscales and total score of the Short Form Health Survey (SF-36), used for assessment of HRQoL in samples of 561 medical and 332 non-medical university students were assessed and compared. In addition, linear regression to identify predictors of better perception of mental and physical components of HRQoL and overall HRQoL in the sample of medical students was used. The dependant variables were subscores and total score with the SF- 36, and independent variables were certain sociodemographic and academic characteristics of the students. Results. Medical students had statistically significantly higher scores on the Mental Component Summary and total SF-36 score compared to non-medical students. Linear regression analysis demonstrated that higher scores of Physical Component Summary were associated with age, male sex and the year of studies. The Mental Component Summary were associated with age, male sex, the year of studies and marital status. The total SF-36 score was associated with age, male sex and the year of studies. Conclusion. Medical students perceive their health much better than other university students do, but female, older and second grade medical students have worse perception of their HRQoL. Those points should be potential target areas for specific prevention and treatment in order to achieve better HRQoL.Uvod/Cilj. Dosadašnje studije subjektivne percepcije zdravlja i kvaliteta života povezanog sa zdravstvenim stanjem (HRQoL) studenata medicine pokazale su kontradiktorne rezultate. Štaviše, ne postoje objavljene studije koje su poredile HRQoL studenata medicine i studenata ne- medicinskih fakulteta. Cilj ove studije bio je da se proceni subjektivna percepcija HRQoL na uzorku studenata medicine, da se uporedi sa percepcijom HRQoL studenata ne- medicinskih fakulteta i da se utvrde prediktori bolje percepcije HRQoL kod studenata medicine. Metode. Uzorak za istraživanje obuhvatio je 561 studenta medicine i 332 studenta ne-medicinskih fakulteta Univerziteta u Beogradu. Istraživanje je obavljeno uz pomoć Short Form Health Survey (SF-36) upitnika koji procenjuje mentalnu i fizičku komponentu, kao i ukupan skor subjektivne procene kvaliteta života vezanog za zdravstveno stanje. Upoređeni su skorovi sa zbirne skale i supskala dve grupe studenata. Pored toga, korišćena je i linearna regresija da bi se procenili prediktori boljeg sagledavanja ukupnog skora i mentalne i fizičke komponente HRQoL na uzorku studenata medicine. Zavisne varijable bile su supskorovi i ukupan skor sa SF- 36 upitnika, a nezavisne varijable sociodemografske i akademske karakteristike ispitanika. Rezultati. Studenti medicine imali su statistički značajno više skorove na supskali mentalnog zdravlja i na ukupnom skoru SF-36 upitnika u odnosu na studente ne-medicinskih fakulteta. Linearna regresija pokazala je da su viši skorovi fizičke komponente povezani sa godinama starosti, muškim polom i godinom studija; viši skorovi mentalne komponente povezani sa godinama starosti, muškim polom, godinom studija i bračnim statusom. Ukupan SF-36 skor povezan je sa godinama starosti, muškim polom i godinom studija. Zaključak. Studenti medicine gledaju na svoje zdravstveno stanje mnogo bolje nego studenti ne-medicinskih fakulteta. Ipak, devojke, stariji studenti i studenti druge godine medicine imaju lošiju percepciju svog kvaliteta života koji se vezuje za zdravlje. Ovo bi trebalo da budu fokusi za specifičnu prevenciju i eventualnu terapiju u cilju postizanja boljeg kvaliteta života studenata medicine

Quantitative Assessment of the Arm/Hand Movements in Parkinson’s Disease Using a Wireless Armband Device

We present an approach for quantitative assessment of the arm/hand movements in patients with Parkinson’s disease (PD), from sensor data acquired with a wearable, wireless armband device (Myo sensor). We propose new Movement Performance Indicators that can be adopted by practitioners for the quantitative evaluation of motor performance and support their clinical evaluations. In addition, specific Movement Performance Indicators can indicate the presence of the bradykinesia symptom. The study includes seventeen PD patients and sixteen age-matched controls. A set of representative arm/hand movements is defined under the supervision of movement disorder specialist. In order to assist the evaluations, and for progress monitoring purposes, as well as for assessing the amount of bradykinesia in PD, a total set of 84 Movement Performance Indicators are computed from the sensor readings. Subsequently, we investigate whether wireless armband device, with the use of the proposed Movement Performance Indicators can be utilized: (1) for objective and precise quantitative evaluation of the arm/hand movements of Parkinson’s patients, (2) for assessment of the bradykinesia motor symptom, and (3) as an adequate low-cost alternative for the sensor glove. We conducted extensive analysis of proposed Movement Performance Indicators and results are indicating following clinically relevant characteristics: (i) adequate reliability as measured by ICC; (ii) high accuracy in discrimination between the patients and controls, and between the disease stages (support to disease diagnosis and progress monitoring, respectively); (iii) substantial difference in comparison between the left-hand and the right-hand movements across controls and patients, as well as between disease stage groups; (iv) statistically significant correlation with clinical scales (tapping test and UPDRS-III Motor Score); and (v) quantitative evaluation of bradykinesia symptom. Results suggest that the proposed approach has a potential to be adopted by physicians, to afford them with quantitative, objective and precise methods and data during clinical evaluations and support the assessment of bradykinesia