53 research outputs found
Effect of Olanzapine on Disruptive Behavior in Institutionalized Patients with Severe Intellectual Disability ā A Case Series
Considerable number of intellectual disabled people experience some form of disruptive behavior. Antipsychotics are
the most common treatment for these behaviors. Numerous patients were efficiently treated with thioridazine, recently
withdrawn. The authors describe a case series of Ā»thioridazine respondersĀ« treated with olanzapine. Thirty three patients
with severe intellectual disability were recruited. All patients were assessed for seven types of disruptive behavior on five
point scale. Patients with severe behavior disturbances were included in treatment. The time points of assessment were
at day 0, 30, 60 and 180. Twenty one patient accomplished inclusion criteria. A significant decrease occurred at day 30
for all types of behavior. Total score, self injurious behavior, compulsive and destructive behavior showed further decrease
at day 60 and became stable until the end of study. Olanzapine appears to be efficacious in the treatment of disruptive
behavior in the intellectually disabled and could be substitute for thioridazine treatment
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QUETIAPINE IN MANAGEMENT OF MANIC SYMPTOMS IN PATIENT WITH HEART TRANSPLANTATION ā A CASE REPORT
Parental involvement in the war in Croatia 1991-1995 and suicidality in Croatian male adolescents
Aim To investigate the association between parental war
involvement and different indicators of psychosocial distress
in a community sample of early adolescents ten years
after the war in Croatia 1991-1995.
Methods A total of 695 adolescents were screened with
a self-report questionnaire assessing parental war involvement,
sociodemographic characteristics, and alcohol and
drug consumption. Personality traits were assessed with
the Junior Eysenck Personality Questionnaire; depressive
symptoms with the Childrenās Depression Inventory (CDI);
and unintentional injuries, physical fighting, and bullying
with the World Health Organization survey Health Behavior
in School-aged Children. Suicidal ideation was assessed
with three dichotomous items. Suicidal attempts were assessed
with one dichotomous item.
Results Out of 348 boys and 347 girls who were included
in the analysis, 57.7% had at least one veteran parent.
Male children of war veterans had higher rates of unintentional
injuries (odds ratio [OR], 1.2; 95% confidence interval
[CI], 0.56 to 2.63) and more frequent affirmative responses
across the full suicidal spectrum (thoughts about death ā
OR, 2.1; 95% CI, 1.02 to 4.3; thoughts about suicide ā OR,
5; 95% CI, 1.72 to 14.66; suicide attempts ā OR, 3.6; 95%
CI, 1.03 to 12.67). In boys, thoughts about suicide and unintentional
injuries were associated with parental war involvement
even after logistic regression. However, girls
were less likely to be affected by parental war involvement,
and only exhibited signs of psychopathology on the CDI
total score.
Conclusion Parental war involvement was associated with
negative psychosocial sequels for male children. This relationship
is possibly mediated by some kind of identification
or secondary traumatization. Suicidality and unintentional
injuries are nonspecific markers for a broad range of
psychosocial distresses, which is why the suggested target
group for preventive interventions should be veteran parents
as vectors of this distress
METABOLIC SYNDROME AND INFLAMMATION MARKERS IN PATIENTS WITH SCHIZOPHRENIA AND RECURRENT DEPRESSIVE DISORDER
Background: The high prevalence of metabolic syndrome in patients with psychiatric disorders, almost double the prevalence
reported for the general population, is worrying. The aim of this study is to investigate the presence of metabolic syndrome and
inflammatory marker levels in patients with schizophrenia and recurrent depressive disorder in a Croatian psychiatric sample.
Subjects and methods: This study included 62 inpatients with schizophrenia and 62 with recurrent depressive disorder treated at
the Department of Psychiatry, University Hospital Centre Split, enrolled from November 2011 until May 2012. The cases were
compared to 124 healthy subjects from the general population.
Results: The presence of metabolic syndrome was found in 56.5% of the patients with schizophrenia and 53.2% of the patients
with depression, which was significantly more prevalent than in the control group (32.3%). The levels of inflammation markers (i.e.,
C-reactive protein and PAI-1) were significantly higher among patients with metabolic syndrome.
Conclusions: Patients with schizophrenia and recurrent depressive disorder demonstrate a high prevalence of metabolic
syndrome that is also related to inflammation processes. In the context of integrative medicine, clinicians and researchers should
consider psychiatric patients within a holistic approach
KirurÅ”ko lijeÄenje metastaza kralježnice
Spinal metastatic disease is a rather common occurrence and definitely warrants attention and treatment due to the high likelihood of leaving cancer patients severely disabled in their final months of life. Recent developments in the understanding of the behavior of different tumor types, as well as advances in surgical treatment, are allowing for the evolution of treatment algorithms, especially when surgical treatment is to be considered. Th is paper gives an overview of the decisionmaking
process and the array of surgical options currently available.Metastatska bolest kralježnice je dosta uÄestala i zasigurno zaslužuje pozornost i lijeÄenje zbog visoke vjerojatnosti da bi inaÄe bolesnici s karcinomom ostali oduzeti u svojim posljednjim mjesecima života. Novija postignuÄa i shvaÄanja ponaÅ”anja raznih tipova tumora te unaprjeÄenja u kirurÅ”kim tehnikama omoguÄuju evoluciju algoritama, pogotovo kada se kirurÅ”ko lijeÄenje razmatra. Ovaj rad daje pregled postupka donoÅ”enja odluka i istiÄe razne kirurÅ”ke moguÄnosti koje su trenutno dostupne
Iskustva akreditacije Instituta za medicinska istraživanja i medicinu rada
Accreditation in accordance with the international General Requirements for the Competence of Testing and Calibration Laboratories (HRN EN ISO/IEC 17025 standard) has become a widely accepted method of quality management and objective evidence of technical competence, knowledge, and skills of testing and calibration laboratories. In 2010, the Institute for Medical Research and Occupational Health (IMROH) had its management system accredited against the HRN EN ISO/IEC 17025 standard for the following scopes: determination of radioactivity, testing of ambient air quality, and testing in the scope of ionising radiation protection. This accreditation encompassed three laboratories: Radiation Protection Unit, Environmental Hygiene Unit, and the Radiation Dosimetry and Radiobiology Unit. In accordance with the rules of the Croatian Accreditation Agency, the second re-accreditation is due in 2020. This paper describes and discusses the quality management system at IMROH over the ten years of its implementation. We share our experiences about non-conformities discovered during regular work, internal audits, and external audits performed by the Croatian Accreditation Agency. The accredited management system significantly improved the performance of the accredited units, and the Institute increased its visibility and marketing advantage, consequently improving its market position.Akreditacija u skladu sa zahtjevima meÄunarodnog standarda HRN EN ISO / IEC 17025 (OpÄi zahtjevi za osposobljenost ispitnih i umjernih laboratorija) postala je praktiÄna i Å”iroko prihvaÄena metoda upravljanja kvalitetom i objektivni dokaz tehniÄke osposobljenosti, znanja i vjeÅ”tina u ispitnim i umjernim laboratorijima. Institut za medicinska istraživanja I medicinu rada (IMROH) akreditirao je 2010. godine svoj sustav upravljanja u skladu sa zahtjevima HRN EN ISO / IEC 17025 norme za sljedeÄa podruÄja primjene: odreÄivanje radioaktivnosti, ispitivanja kvalitete zraka te ispitivanja u podruÄju zaÅ”tite od ionizirajuÄega zraÄenja. Akreditacija je obuhvaÄala tri laboratorija: Jedinicu za zaÅ”titu od zraÄenja, Jedinicu za higijenu okoline i Jedinicu za dozimetriju zraÄenja i radiobiologiju. U skladu s pravilima Hrvatske akreditacijske agencije, u 2020. godini planira se druga reakreditacija Instituta. U radu je opisan sustav upravljanja kvalitetom u IMROH-u i iskustva steÄena tijekom desetogodiÅ”njeg razdoblja. Analizirane su nesukladnosti otkrivene tijekom redovitog rada, u internim auditima te u vanjskim auditima koje je provodila Hrvatska akreditacijska agencija, tj. nacionalno akreditacijsko tijelo u Hrvatskoj. Može se zakljuÄiti da je akreditirani sustav upravljanja znaÄajno poboljÅ”ao rad ukljuÄenih akreditiranih jedinica, a Institut je poveÄao vidljivost na tržiÅ”tu i marketinÅ”ku prednost te posljediÄno poboljÅ”ao svoju tržiÅ”nu poziciju
Infections of the musculoskeletal system ā review article
Uvod: Infekcije lokomotornog sustava mogu se podijeliti u nekoliko osnovnih skupina ovisno o lokalizaciji, vremenu trajanja i prisutnosti stranog materijala. KirurÅ”ke infekcije poveÄavaju morbiditet i mortalitet bolesnika, financijski troÅ”ak lijeÄenja te predstavljaju golemi globalni javnozdravstveni problem. LijeÄenje infekcija lokomotornog sustava može biti antibiotsko ili kirurÅ”ko, a najÄeÅ”Äe je potrebno kombinirati ove dvije metode.
Cilj rada: Cilj je ovog rada dati pregled infekcija lokomotornog sustava s kojima se susreÄu ortopedi i traumatolozi u svojem radu, uz pregled suvremene literature dostupne na ovu temu.
Rasprava: U raspravi su prikazane sve infekcije lokomotornog sustava i za svaku su opisane kliniÄka slika, dijagnostika i suvremene opcije lijeÄenja.
ZakljuÄak: Možemo zakljuÄiti da su sve infekcije miÅ”iÄno-koÅ”tanog sustava potencijalno vrlo teÅ”ka stanja koja, ako se na vrijeme ne prepoznaju i ne lijeÄe, mogu zavrÅ”iti trajnom invalidnoÅ”Äu, daljnjim hematogenim Å”irenjem bakterija i razvojem sepse, pa Äak i smrÄu bolesnika.Introduction: Infections of the musculoskeletal system can be divided into several basic groups depending on localization, duration and the presence of foreign material. Surgical infections increase the morbidity and mortality of patients, the financial cost of treatment, and represent a huge public health problem globally. Treatment of musculoskeletal infections can involve the use of antibiotics or surgery, and most often it is necessary to combine these two methods.
Aim: The aim of this paper is to provide an overview of the musculoskeletal infections that orthopedic and trauma surgeons encounter in their work, along with an overview of the literature available on this topic.
Discussion: In the discussion, all infections of the musculoskeletal system are presented individually and the clinical presentation, diagnostics and modern treatment options are described for each.
Conclusion: We can conclude that all infections of the musculoskeletal system are potentially very serious conditions that, if not recognized and treated in time, can end in permanent disability, further hematogenous spread of bacteria and the development of sepsis, and even the death of the patien
Mosses and Some Mushroom Species as Bioindicators of Radiocaesium Contamination and Risk Assessment
Mosses, lichens, mushrooms are able to efficiently accumulate different radioactive elements from their environment
to a much higher degree than other vegetation. They are sensitive bioindicators of radioactive contamination for various
ecosystems, particularly in the event of a nuclear accident and uncontrolled emission oh fission products. Results of systematic,
long-term measurements of 137Cs activities in mosses and in some edible mushroom species in North Croatia for
the post-Chernobyl period (1986ā2007) are summarized. The study was conducted in the Radiation Protection Unit of
the Institute for Medical Research and Occupational Health in Zagreb, as a part of an extensive monitoring program of
the Croatian environment. In the overall observed period the highest activity concentration of 137Cs deposited by fallout
has been recorded in 1986, which is the year of Chernobyl accident, causing peak 137Cs activity concentration in moss of
8800 Bq/kg in May 1986. In the same period mean 137Cs activity concentration in grass was 390 Bq/kg. The highest value
of 137Cs activity concentration in Cortinarius caperatus mushrooms of 1351 Bq/kg has been recorded in 1989. Fitting the
measured 137Cs activity concentrations to the theoretical curve the ecological half-life of 137Cs in moss was found to be
around 978 days, in grass around 126 days in the period 1986ā1990, in Cortinarius caperatus mushroom around 5865
days (16.1 years). Regarding the risk assessment to Croatian population, due to consumption of mushrooms, the collective
effective dose for Croatian population, estimated to be about 35 mSv per year, was found to be quite low. Therefore, it
can be concluded that mushroom consumption was not a critical pathway for the transfer of radiocaesium from fallout to
humans after the Chernobyl accident
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