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G. Mihajlović, Natalija Jovanović-Mihajlović, B. Radmanovic, K. Radonjic, S. Djukić-Dejanović, S. Janković, V. Janjić, N. Milovanović et al.

INTRODUCTION In the last decades psychiatric patients' quality of life attracts great attention of researchers. Improving the quality of life of schizophrenic patients is increasingly becoming an imperative in pharmacological therapy. OBJECTIVE Analysis of certain aspects of quality of life in patients with schizophrenia treated with depot formulations of a typical antipsychotic (haloperidol) and injection preparation of a long-acting atypical antipsychotic (risperidone). METHODS Research was conducted as a cross-sectional study that included 60 patients of both genders. Examinees diagnosed with schizophrenia (ICD-10, F20.0-F20.9) were divided into two groups: the group of patients that received haloperidol depot (n = 30) and the group of patients that received injection preparation of long-acting risperidone (n = 30). In order to assess the quality of life, social functioning scale (SFS), satisfaction with life scale (SWLS), and short version of World Health Organization quality of life scale (WHO-QoL-Brief) were applied. RESULTS Results showed statistically significant differences when it comes to social activity and satisfaction with life in favour of patients treated with injection preparation of long-acting risperidone. Examinees from this group were much more satisfied with themselves, their health and sleep compared to those on haloperidol depot. There was no statistically significant difference found on the quality of life scale. CONCLUSIONS Applying the scales for the assessment of the quality of life of schizophrenic patients in terms of psychosocial functioning, statistically significant difference between groups was found. Results showed higher scores in the group of patients treated with injection preparation of long-acting risperidone concerning social activities and life satisfaction.

G. Vasić, G. Mihajlović, Natalija Jovanović-Mihajlović, M. Rafajlović, J. Barišić, S. Djukić-Dejanović, S. Janković, K. Radonjic

INTRODUCTION Some research results point to significant benefit in the use of methadone substitution treatment in reduction of criminogenic activities in opiate addicts, as in positive affect on their somatic and mental state. OBJECTIVE The objective of the study was to indicate factors which lead to criminogenic activities in addicts with judicial problems before entering substitute, methadone program. METHODS Addicts were divided into two groups: addicts who had judicial problems before they entered substitution methadone program (group A-46 addicts) and addicts withoutjudicial problems (group B-20 addicts). A questionnaire containing basic data about the addicts in the treatment program (Pompidou questionnaire) was for questioning. RESULTS A statistically significant difference was recorded related to the way of taking PAS. The largest number of examinees from the group A took primal PAS intravenously (41; 89.1%), while from the group B 11 took it intravenously (55.0%). The majority of examinees in the group A committed the first criminal act before taking PAS (psychoactive substances) (19; 41.3%), then after taking so-called harder PAS (16; 34.8%), and finally after taking the so-called lighter PAS (11; 23.9%). In somewhat over half of the examinees in the group A (24; 52.2%) the measure of juvenile court was imposed. A suspended sentence was passed upon 19 (41.3%) examinee, then prison sentence in 16 (34.8%), multiple prison sentences in 6 (13.0%) and misdemeanour in 4 (8.7%). CONCLUSION Future research at our centre should show the efficiency of methadone program in a decrease of risky behaviour, degree of criminogenic activity and judicial problems, improvement of life quality, as well as show the ways for preventive acting.

L. Neefjes, A. Dharampal, A. Rossi, K. Nieman, A. Weustink, M. Dijkshoorn, G. T. ten Kate, A. Dedic et al.

PURPOSE To compare image quality, radiation dose, and their relationship with heart rate of computed tomographic (CT) coronary angiographic scan protocols by using a 128-section dual-source CT scanner. MATERIALS AND METHODS Institutional review board approved the study; all patients gave informed consent. Two hundred seventy-two patients (175 men, 97 women; mean ages, 58 and 59 years, respectively) referred for CT coronary angiography were categorized according to heart rate: less than 65 beats per minute (group A) and 65 beats per minute or greater (group B). Patients were randomized to undergo prospective high-pitch spiral scanning and narrow-window prospective sequential scanning in group A (n = 160) or wide-window prospective sequential scanning and retrospective spiral scanning in group B (n = 112). Image quality was graded (1 = nondiagnostic; 2 = artifacts present, diagnostic; 3 = no artifacts) and compared (Mann-Whitney and Student t tests). RESULTS In group A, mean image quality grade was significantly lower with high-pitch spiral versus sequential scanning (2.67 ± 0.38 [standard deviation] vs 2.86 ± 0.21; P < .001). In a subpopulation (heart rate, <55 beats per minute), mean image quality grade was similar (2.81 ± 0.30 vs 2.94 ± 0.08; P = .35). In group B, image quality grade was comparable between sequential and retrospective spiral scanning (2.81 ± 0.28 vs 2.80 ± 0.38; P = .54). Mean estimated radiation dose was significantly lower (high-pitch spiral vs sequential scanning) in group A (for 100 kV, 0.81 mSv ± 0.30 vs 2.74 mSv ± 1.14 [P < .001]; for 120 kV, 1.65 mSv ± 0.69 vs 4.21 mSv ± 1.20 [P < .001]) and in group B (sequential vs retrospective spiral scanning) (for 100 kV, 4.07 mSv ± 1.07 vs 5.54 mSv ± 1.76 [P = .02]; for 120 kV, 7.50 mSv ± 1.79 vs 9.83 mSv ± 3.49 [P = .1]). CONCLUSION A high-pitch spiral CT coronary angiographic protocol should be applied in patients with regular and low (<55 beats per minute) heart rates; a sequential protocol is preferred in all others.

M. Pavlovic, R. Šeparović, M. Vukelić-Marković, L. Patrlj, M. Kolovrat, M. Kopljar, N. Babić, D. Košuta et al.

Isolated splenic metastasis arising from a colorectal carcinoma is a rare finding. We report a case of 74-year-old man with a medical history of diabetes type II and paroxysmal atrial fibrillation, who underwent a right hemicolectomy for an adenocarcinoma of caecum in August 2004. In June 2007 the patient was diagnosed with high grade aortic valve stenosis as well as long segment stenosis of the first obtuse marginal branch of left coronary artery. He was suggested aortic valve replacement with coronary artery bypass grafting but he refused the surgery. In October 2007 the patient underwent alpha 18FDG - PET scanning, due to increasing values of CEA serum level, which showed a 5 cm big isolated hypermetabolic lesion in the spleen. Due to operative risk, splenectomy was refused by surgeons. The patient underwent a chemotherapy with capecitabine in total of 8 cycles before his CEA level began to rise and MSCT showed a progression in size of splenic metastasis. The patients condition was reevaluated by a team of experts and splenectomy was performed in September 2008. In May 2009 during the postoperative follow up, MSCT scanning revealed enlarged lymph nodes in celiac region and hepatic lesion suspicious of metastasis and the patient was admitted for further chemotherapy treatment. There is still no standardized treatment for this condition due to small number of cases reported in literature. Splenectomy followed by chemotherapy seems to be an optimal treatment but still no final conclusions can be made.

R. Hodžić, Nermina Pirić, Mirsad Hodžić, B. Kojić

Electrophysiological Evaluation of the Incidence of Martin-Gruber Anastomosis in Healthy Bosnian Population Background: Martin-Gruber anastomosis (MGA) is the well known anostomosis that occur at the various levels between the median and ulnar nerves. This anastomosis involves axons leaving either the main trunk of median nerve or the anterior interosseous nerve, crossing through the forearm to join the ulnar nerve. Knowledge of the incidence of this anastomosis is necessary because MGA can cause confusion in the assesment of nerve injuries and compressive neuropathies. Aim: We aimed to assess the occurance and motor velocities of median to ulnar nerve communication (MGA) in the forearm of Bosnian population by electrophysiological examinations. Material and Methods: One hundred and twenty forearms from a series of 60 volunteers (25 females, 35 males, 23-78 years of age) were studied electrophysiologically using needle recording electrodes. Volunteers with peripheral neuropathies were excluded from the study. Needle recording electrodes were places on the thenar and hypothenar muscles. The median and ulnar nerves were stimulated supramaximally at the wrist and the elbow and compound muscle action potentials (CMAPs) were recorded as well as motor conduction velocities of median and ulnar nerves. Results: Martin-Gruber anastomosis was found in 27 of 120 forearms; it was bilateral in 7 and unilateral in 13, on the right side in nine and on the left side in four forearms. There were no significant sexual differences in the incidence. In MGA, when stimulating median nerve the respond of abductor digiti minimi was registered in 11, whereas the respond of opponens pollicis when stimulating ulnar nerve was registered in 18 subjects. This finding was statistically significant. Conclusion: With high incidence of MGA in Bosnian population, it is necessary to be aware of the existance of this anomaly, location and its possible presentation.

Uvod. Analizirati elemente interakcije koji doprinose uspostavljanju kvalitetau komunikaciji između ljekara i bolesnika sa dijabetesom na nivou primarnezdravstvene zastite. Analizirati uticaj odnosa ljekar - bolesnik na ishodelijecenja dijabetesa.Metode. Studijom je obuhvaceno osam ljekara i sezdeset bolesnika oboljelihod dijabetes mellitus-a tip 2, izabranih prema specificnim kriterijumima.Ljekari su podijeljeni u dvije grupe. Eksperimentalnu grupu su cinili ljekarisa zavrsenom obukom iz komunikologije. Kontrolnu grupu su cinila cetiriljekara opste prakse bez obuke iz medicinske komunikologije. Svaki ljekar jepratio grupu od sedam ili osam bolesnika sa dijabetesom.Interakcija između ljekara i bolesnika je procjenjivana primjenom Bales-oveanalize interakcijskog procesa. Tokom devet mjeseci praceni su funkcionalniishodi tretmana, vrijednosti glikemije i HbA1c, saradnja i zadovoljstvo bolesnika.Rezultati. Razlike u ponasanja ljekara eksperimentalne i kontrolne grupe subile visoko znacajne po svim kategorijama Bales-ove analize. Kontrola vrijednostiglikemije i Hb1Ac je bila bolja kod ispitanika koji su: imali kontrolunad konsultacijom, aktivno ucestvovali u lijecenju, pokazivali emocije, tražiliinformacije i razmjenjivali misljenje sa ljekarom. Ispitanici eksperimentalnegrupe su imali statisticki znacajna poboljsanja funkcionalnih parametara imanje funkcionalnih ogranicenja nakon devet mjeseci, te su bili statistickiznacajno zadovoljniji njegom i karakteristikama ljekara.Zakljucak. Dobra komunikacija sa bolesnikom znacajno utice na poboljsanjeishoda lijecenja bolesnika sa dijabetesom. Praktikovanje modela njege usmjereneka bolesniku dovodi do potpunije razmjene informacija između bolesnika iljekara, vece zdravstvene aktivnosti i odgovornosti bolesnika, te uspostavljanjaefikasnije saradnje i zadovoljstva bolesnika. Obuku iz medicinske komunikologijetreba sprovoditi na svim nivoima studija medicine.

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