7 research outputs found
From antisocial personality disorder to psychopathy
Antisocijalni poremeÄaj liÄnosti spada u ācluster Bā poremeÄaje liÄnosti. Karakteriziran je kriminalnim ponaÅ”anjem, egocentrizmom, deficitom empatije, manipulativnoÅ”Äu i dezinhibicijom, a obrazac ponaÅ”anja je stabilan tijekom vremena. Radi se o takvom poremeÄaju liÄnosti koji, osim Å”to je znaÄajan problem za oboljelog pojedinca i njegovu užu okolinu, predstavlja i važan socijalni problem. Prevalencija nije zanemariva ā 2 do 4 % u opÄoj populaciji, a praÄen je nezaposlenoÅ”Äu, psihiÄkim i somatskim komorbiditetima i niskim životnim standardom. Psihopatiju je kao dijagnozu u psihijatriju uveo Cleckley joÅ” 1941. na temelju vlastitog kliniÄkog iskustva, a prvi dijagnostiÄki alat je osmislio Robert Hare u obliku Äek-liste za psihopate. Danas se koristi njena revidirana verzija iz 1991. godine. Karakteristike psihopatije se dijele na dva faktora. Prvi predstavlja afektivno-interpersonalnu dimenziju koja se odnosi na Å”arm, grandioznost, povrÅ”an afekt, patoloÅ”ko laganje i nedostatak empatije. Drugi faktor psihopatije je socijalno-devijantna dimenzija koja zapravo nalikuje antisocijalnom poremeÄaju liÄnosti: parazitski i kriminalni stil života te impulzivnost. OpÄenito se smatra da postoji takozvani kontinuum narcistiÄnog spektra unutar kojeg se karakteristike liÄnosti od malignog narcizma, preko razliÄitih stupnjeva antisocijalnog i psihopatskog ponaÅ”anja do punog oblika antisocijalnog poremeÄaja liÄnosti i psihopatije, promatraju kao razliÄiti stupnjevi jednog te istog poremeÄaja liÄnosti. LijeÄenje pacijenata s ovakvim crtama liÄnosti je dugotrajno, sporo i sa, do sada, skromnim napretkom. Koristi se pretežno metoda razvijanja mentalizacije kroz terapijski savez i korektivno iskustvo. Jedino Å”to preostaje kako bi se postigao dodatni uspjeh i razumijevanje je provoÄenje daljnjih istraživanja, evaluacija dosadaÅ”njeg rada i angažiranje ne samo medicine veÄ i ostalih segmenata druÅ”tva ā pravosudnih tijela i socijalnih službi.Antisocial personality disorder is classified in ācluster Bā. Characteristics of this personality disorder are criminally deviant behavior, egocentrism, empathy deficit, manipulative behavior, and disinhibition. These characteristic behaviors are a long-term pattern of individual's functioning. The prevalence of antisocial personality disorder is 2 to 4 %, and many comorbidities (psychic and somatic) make it very important for the patient alone, but also for the society. In 1941, based on his clinical observations, Cleckley came up with the term of psychopathy. Later, Robert Hare made the first diagnostic tool used to rate an individual's psychopatic or antisocial tendencies. Nowaday, Psyhcopathy Checklist ā Revised is used for these purposes. Characteristics of psychopathy are divided in two factors. First deals with affective component of individual's character and includes charm, pathological lying, and empathy deficit. Second factor deals with behavioral component of psychopathy and includes impulsiveness and criminally deviant behavior. It is considered that antisocial personality disorder, psychopathy, and narcissism are all together a part of the Narcissistic continuum. They are considered as different presentations of very similar personality disorders which can't be strictly separated. Treatnig these patients is considered to be complicated, long-term, and with high failure rates. Up to now, the best treatment method has been encouraging the development of mentalization. To acomplish further progress in treating antisocial personality disorder and psychopathy, it is necessary to conduct more research, reassess previous work, and engage not only medicine, but also judicial institutions and social services
From antisocial personality disorder to psychopathy
Antisocijalni poremeÄaj liÄnosti spada u ācluster Bā poremeÄaje liÄnosti. Karakteriziran je kriminalnim ponaÅ”anjem, egocentrizmom, deficitom empatije, manipulativnoÅ”Äu i dezinhibicijom, a obrazac ponaÅ”anja je stabilan tijekom vremena. Radi se o takvom poremeÄaju liÄnosti koji, osim Å”to je znaÄajan problem za oboljelog pojedinca i njegovu užu okolinu, predstavlja i važan socijalni problem. Prevalencija nije zanemariva ā 2 do 4 % u opÄoj populaciji, a praÄen je nezaposlenoÅ”Äu, psihiÄkim i somatskim komorbiditetima i niskim životnim standardom. Psihopatiju je kao dijagnozu u psihijatriju uveo Cleckley joÅ” 1941. na temelju vlastitog kliniÄkog iskustva, a prvi dijagnostiÄki alat je osmislio Robert Hare u obliku Äek-liste za psihopate. Danas se koristi njena revidirana verzija iz 1991. godine. Karakteristike psihopatije se dijele na dva faktora. Prvi predstavlja afektivno-interpersonalnu dimenziju koja se odnosi na Å”arm, grandioznost, povrÅ”an afekt, patoloÅ”ko laganje i nedostatak empatije. Drugi faktor psihopatije je socijalno-devijantna dimenzija koja zapravo nalikuje antisocijalnom poremeÄaju liÄnosti: parazitski i kriminalni stil života te impulzivnost. OpÄenito se smatra da postoji takozvani kontinuum narcistiÄnog spektra unutar kojeg se karakteristike liÄnosti od malignog narcizma, preko razliÄitih stupnjeva antisocijalnog i psihopatskog ponaÅ”anja do punog oblika antisocijalnog poremeÄaja liÄnosti i psihopatije, promatraju kao razliÄiti stupnjevi jednog te istog poremeÄaja liÄnosti. LijeÄenje pacijenata s ovakvim crtama liÄnosti je dugotrajno, sporo i sa, do sada, skromnim napretkom. Koristi se pretežno metoda razvijanja mentalizacije kroz terapijski savez i korektivno iskustvo. Jedino Å”to preostaje kako bi se postigao dodatni uspjeh i razumijevanje je provoÄenje daljnjih istraživanja, evaluacija dosadaÅ”njeg rada i angažiranje ne samo medicine veÄ i ostalih segmenata druÅ”tva ā pravosudnih tijela i socijalnih službi.Antisocial personality disorder is classified in ācluster Bā. Characteristics of this personality disorder are criminally deviant behavior, egocentrism, empathy deficit, manipulative behavior, and disinhibition. These characteristic behaviors are a long-term pattern of individual's functioning. The prevalence of antisocial personality disorder is 2 to 4 %, and many comorbidities (psychic and somatic) make it very important for the patient alone, but also for the society. In 1941, based on his clinical observations, Cleckley came up with the term of psychopathy. Later, Robert Hare made the first diagnostic tool used to rate an individual's psychopatic or antisocial tendencies. Nowaday, Psyhcopathy Checklist ā Revised is used for these purposes. Characteristics of psychopathy are divided in two factors. First deals with affective component of individual's character and includes charm, pathological lying, and empathy deficit. Second factor deals with behavioral component of psychopathy and includes impulsiveness and criminally deviant behavior. It is considered that antisocial personality disorder, psychopathy, and narcissism are all together a part of the Narcissistic continuum. They are considered as different presentations of very similar personality disorders which can't be strictly separated. Treatnig these patients is considered to be complicated, long-term, and with high failure rates. Up to now, the best treatment method has been encouraging the development of mentalization. To acomplish further progress in treating antisocial personality disorder and psychopathy, it is necessary to conduct more research, reassess previous work, and engage not only medicine, but also judicial institutions and social services
KroniÄne nezarazne bolesti kod hrvatskih branitelja u odnosu na opÄu populaciju: 25 godina nakon rata
Many published reports have documented an increased prevalence of chronic
medical conditions among veterans, but there were only a few studies that compared these increases
with the general population. The aim of this study was to determine differences in chronic medical
conditions between Croatian war veterans and the general population. This study included two
groups of subjects, i.e. 1453 participants who are Croatian war veterans and 1429 participants from
the general population. Medical history, physical examination, laboratory tests and specific diagnostic
procedures were taken during systematic physical examination in both groups. The prevalence
of hypertension, diabetes, hyperlipidemia, hypothyroidism and hyperthyroidism, chronic obstructive
pulmonary disease, coronary heart disease, malignancy, psychiatric diseases, cholelithiasis, nephrolithiasis,
smoking and alcohol consumption was analyzed. Croatian war veterans were found to be more
likely to develop hypertension than individuals in the general population (29.5% vs. 24.3%), as well
as diabetes (7.3% vs. 3.8%), hyperlipidemia (56.4% vs. 27.3%), hyperthyroidism (3.1% vs. 0.8%), coronary
heart disease (4.3% vs. 1 %), malignancy (4.1% vs. 2.2%), psychiatric diseases (15.4% vs. 1.1%),
and alcohol consumption (53% vs. 29%). Significant difference was found in favor of the general
population for hypothyroidism (14.3% vs. 8%). There were no differences in the prevalence of chronic
obstructive pulmonary disease, cholelithiasis, nephrolithiasis, and smoking. Our findings confirmed
the hypothesis of a higher prevalence of cardiovascular diseases, malignancy and psychiatric diseases
among Croatian war veterans and emphasized the need of better control of their medical conditions.PoveÄana uÄestalost kroniÄnih bolesti meÄu veteranima dokumentirana je kroz brojna istraživanja, no samo ih je nekoliko
studija usporeÄivalo s opÄom populacijom. Cilj ovog istraživanja bio je utvrditi razlike u pojavnosti kroniÄnih bolesti izmeÄu
hrvatskih branitelja i opÄe populacije. Ovo istraživanje obuhvatilo je dvije skupine ispitanika, 1453 hrvatskih branitelja i
1429 sudionika iz opÄe populacije. Anamneza, fizikalni pregled, laboratorijske pretrage i specifiÄni dijagnostiÄki postupci
provedeni su tijekom sistematskog fizikalnog pregleda u obje skupine. Analizirana je uÄestalost hipertenzije, Å”eÄerne bolesti,
hiperlipidemije, hipotireoze i hipertireoze, kroniÄne opstruktivne pluÄne bolesti, koronarne bolesti, malignih bolesti, psihijatrijskih
bolesti, kolelitijaze, nefrolitijaze, puÅ”enja i konzumacije alkohola. UtvrÄeno je da hrvatski branitelji imaju veÄu
vjerojatnost za razvoj hipertenzije (29,5% prema 24,3%), dijabetesa (17,3% prema 3,8%), hiperlipidemije (56,4% prema
27,3%), hipertireoze (3,1% prema 0,8%), koronarne bolesti srca (4,3% naspram 1%), zloÄudne bolesti (4,1% naspram 2,2%),
psihijatrijske bolesti (15,4% naspram 1,1%) i ÄeÅ”Äu konzumaciju alkohola (53% naspram 29%) nego pojedinci u opÄoj populaciji.
UoÄena je znaÄajna razlika u korist opÄe populacije za hipotireozu (14,3% naspram 8%). Nije bilo razlika u uÄestalosti
kroniÄne opstruktivne pluÄne bolesti, kolelitijaze, nefrolitijaze i puÅ”enja. NaÅ”i nalazi potvrdili su hipotezu o viÅ”oj uÄestalosti
kardiovaskularnih bolesti, malignih i psihijatrijskih bolesti meÄu hrvatskim braniteljima te naglasili potrebu bolje kontrole
njihovog zdravstvenog stanja
From antisocial personality disorder to psychopathy
Antisocijalni poremeÄaj liÄnosti spada u ācluster Bā poremeÄaje liÄnosti. Karakteriziran je kriminalnim ponaÅ”anjem, egocentrizmom, deficitom empatije, manipulativnoÅ”Äu i dezinhibicijom, a obrazac ponaÅ”anja je stabilan tijekom vremena. Radi se o takvom poremeÄaju liÄnosti koji, osim Å”to je znaÄajan problem za oboljelog pojedinca i njegovu užu okolinu, predstavlja i važan socijalni problem. Prevalencija nije zanemariva ā 2 do 4 % u opÄoj populaciji, a praÄen je nezaposlenoÅ”Äu, psihiÄkim i somatskim komorbiditetima i niskim životnim standardom. Psihopatiju je kao dijagnozu u psihijatriju uveo Cleckley joÅ” 1941. na temelju vlastitog kliniÄkog iskustva, a prvi dijagnostiÄki alat je osmislio Robert Hare u obliku Äek-liste za psihopate. Danas se koristi njena revidirana verzija iz 1991. godine. Karakteristike psihopatije se dijele na dva faktora. Prvi predstavlja afektivno-interpersonalnu dimenziju koja se odnosi na Å”arm, grandioznost, povrÅ”an afekt, patoloÅ”ko laganje i nedostatak empatije. Drugi faktor psihopatije je socijalno-devijantna dimenzija koja zapravo nalikuje antisocijalnom poremeÄaju liÄnosti: parazitski i kriminalni stil života te impulzivnost. OpÄenito se smatra da postoji takozvani kontinuum narcistiÄnog spektra unutar kojeg se karakteristike liÄnosti od malignog narcizma, preko razliÄitih stupnjeva antisocijalnog i psihopatskog ponaÅ”anja do punog oblika antisocijalnog poremeÄaja liÄnosti i psihopatije, promatraju kao razliÄiti stupnjevi jednog te istog poremeÄaja liÄnosti. LijeÄenje pacijenata s ovakvim crtama liÄnosti je dugotrajno, sporo i sa, do sada, skromnim napretkom. Koristi se pretežno metoda razvijanja mentalizacije kroz terapijski savez i korektivno iskustvo. Jedino Å”to preostaje kako bi se postigao dodatni uspjeh i razumijevanje je provoÄenje daljnjih istraživanja, evaluacija dosadaÅ”njeg rada i angažiranje ne samo medicine veÄ i ostalih segmenata druÅ”tva ā pravosudnih tijela i socijalnih službi.Antisocial personality disorder is classified in ācluster Bā. Characteristics of this personality disorder are criminally deviant behavior, egocentrism, empathy deficit, manipulative behavior, and disinhibition. These characteristic behaviors are a long-term pattern of individual's functioning. The prevalence of antisocial personality disorder is 2 to 4 %, and many comorbidities (psychic and somatic) make it very important for the patient alone, but also for the society. In 1941, based on his clinical observations, Cleckley came up with the term of psychopathy. Later, Robert Hare made the first diagnostic tool used to rate an individual's psychopatic or antisocial tendencies. Nowaday, Psyhcopathy Checklist ā Revised is used for these purposes. Characteristics of psychopathy are divided in two factors. First deals with affective component of individual's character and includes charm, pathological lying, and empathy deficit. Second factor deals with behavioral component of psychopathy and includes impulsiveness and criminally deviant behavior. It is considered that antisocial personality disorder, psychopathy, and narcissism are all together a part of the Narcissistic continuum. They are considered as different presentations of very similar personality disorders which can't be strictly separated. Treatnig these patients is considered to be complicated, long-term, and with high failure rates. Up to now, the best treatment method has been encouraging the development of mentalization. To acomplish further progress in treating antisocial personality disorder and psychopathy, it is necessary to conduct more research, reassess previous work, and engage not only medicine, but also judicial institutions and social services
Access site complications following cardiac catheterization assessed by duplex ultrasonography
Access site complications are major source of morbidity following cardiac catheterization. Their incidence varies in the literature because of multiple definitions and methods of determining the presence of particular complication. The aim of this prospective study was to determine the incidence of access site complications following cardiac catheterization using arterial duplex ultrasonography. A total of 319 consecutive patients, who had cardiac catheterization underwent femoral artery duplex study 24 to 48 hours following manual hemostasis. Diagnostic angiogram had 232 (71.8%) while 87 (28.2%) had percutaneous coronary intervention (PCI). Femoral artery duplex ultrasound was normal in 247 (77.4%). Haematoma was found in 48 (15.1%), pseudoaneurysm in 17 (5.3%), AV fistula in 2 (0.6%) and dissection of the femoral artery in 5 (1.6%) patients. Baseline demografic characteristics were similar in group with normal duplex study and group with detected complication. Pseudoaneurysm and AV fistula were more commonly observed in patients following PCI than diagnostic angiogram (9.2% vs. 4.7%, p<0.001). Patients with documented complications more frequently had concomitant administration of antiplatelet and anticoagulant medication compared to the patients without complications (p=0.003). Hemodynamic disturbances (hypotension and bradycardia) during manual compression were more frequent in patients with complication (11% vs. 4.5%, p=0.047). Low threshold for use of duplex ultrasound should be exercised in patients following cardiac catheterization to establish the presence of access site complications. Special attention is needed in the setting of aggressive antiplatelet and anticoagulant therapy, interventional procedures and hemodynamic disturbances during manual hemostas
Chronic Medical Conditions in Croatian War Veterans Compared to the General Population: 25 Years after the War
Many published reports have documented an increased prevalence of chronic
medical conditions among veterans, but there were only a few studies that compared these increases
with the general population. The aim of this study was to determine differences in chronic medical
conditions between Croatian war veterans and the general population. This study included two
groups of subjects, i.e. 1453 participants who are Croatian war veterans and 1429 participants from
the general population. Medical history, physical examination, laboratory tests and specific diagnostic
procedures were taken during systematic physical examination in both groups. The prevalence
of hypertension, diabetes, hyperlipidemia, hypothyroidism and hyperthyroidism, chronic obstructive
pulmonary disease, coronary heart disease, malignancy, psychiatric diseases, cholelithiasis, nephrolithiasis,
smoking and alcohol consumption was analyzed. Croatian war veterans were found to be more
likely to develop hypertension than individuals in the general population (29.5% vs. 24.3%), as well
as diabetes (7.3% vs. 3.8%), hyperlipidemia (56.4% vs. 27.3%), hyperthyroidism (3.1% vs. 0.8%), coronary
heart disease (4.3% vs. 1 %), malignancy (4.1% vs. 2.2%), psychiatric diseases (15.4% vs. 1.1%),
and alcohol consumption (53% vs. 29%). Significant difference was found in favor of the general
population for hypothyroidism (14.3% vs. 8%). There were no differences in the prevalence of chronic
obstructive pulmonary disease, cholelithiasis, nephrolithiasis, and smoking. Our findings confirmed
the hypothesis of a higher prevalence of cardiovascular diseases, malignancy and psychiatric diseases
among Croatian war veterans and emphasized the need of better control of their medical conditions
IzvjeŔtaj Hrvatskog registra biopsija nativnih bubrega za 2019. godinu
Background: This report describes data collected by the Croatian Registry of Renal
Biopsies (CRRB) for the year 2019. Patients and methods: nine centers (82%) provided data for 255
native kidney biopsies. We assessed
the anthropometric data, data on serum creatinine concentration
(sCr), 24 h proteinuria, haematuria, serum albumin level, arterial hypertension, histological diagnosis,
and complications after renal biopsy. Results: examined group consisted of 58% males, median age 58
y (18-80 y) and 42% women, median age 57 y (20-86 y). Males had a more impaired renal function at
the time of renal biopsy, nephrotic
syndrome, and hypertension. The most prevalent clinical presentation
were urinary abnormalities (34.9%). Among all biopsy cases, primary glomerular diseases were
the most often found histology group (41.5%), and IgA nephropathy was the most frequent diagnosis(
47.1%). Among secondary
glomerular diseases, pauci-immune glomerulonephritis (PIGN) was
most often found (30.9%). The highest proteinuria was observed in minimal change disease and diabetic
nephropathy (DN). The highest sCR values were found in membranoproliferative glomerulonephritis
(MPGN) and necrotizing vasculitis. Patients with MPGN and DN had the highest blood
pressure levels. Conclusion: CRRB provides important data on the epidemiology of biopsy-proven
kidney diseases from the whole territory of CroatiaUvod: izvjeŔtaj opisuje podatke Hrvatskog registra biopsija nativnih bubrega za 2019.godinu. Ispitanici i metode: poslani
su podaci za 255 biopsija nativnih bubrega. Evidentirana je dob, spol, antropometrijski podaci, serumski kreatinin, 24h proteinurija,
eGFR, prisutnost eritrociturije, arterijski tlak, kliniÄka prezentacija, histoloÅ”ka slika i komplikacije biopsije bubrega.
Rezultati: ispitivanu grupu Äinilo je 58% muÅ”karaca, medijan dobi 58 g (18-80 g) i 42% žena, medijan dobi 57 g(20-86 g).
MuÅ”karci su se ÄeÅ”Äe prezentirali azotemijom u Äasu biopsije (67,5 %), nefrotskim sindromom (55,7 %) i hipertenzijom
(62,5 %). NajÄeÅ”Äe kliniÄka prezentacija zbog koje je uÄinjena biopsija bubrega bio je sindrom eritrociturije i proteinurije
(34,9 %). NajÄeÅ”Äa skupina bubrežnih bolesti su bile primarne glomerulopatije (41,5 %). MeÄu primarnim glomerularnim
bolestima najuÄestalija je IgA nefropatija (IgAN)(47,1 %), a meÄu sekundarnim glomerulonefritisima pauci imuni glomerulonefritis
(PIGN) (30,9 %). NajviŔom proteinurijom manifestirali su se od primarnih glomerularnih bolesti bolest minimalnih
promjena a od sekundarnih formi dijabetiÄka nefropatija (DN). NajviÅ”im vrijednostima kreatinina u Äasu biopsije manifestirali
su se MPGN i PIGN. Hipertenzija je bila najviÅ”a kod MPGN i DN. UÄestalost ozbiljnih komplikacija zabilježena
je u 14 bolesnika (5,8 %). ZakljuÄak: rezultati ukazuju na važne epidemioloÅ”ke podatke prikupljene iz reprezentativnog broja
nefroloŔkih centara s cijelog teritorija Republike Hrvatske