Helena Jagodic - Academia.edu (original) (raw)
Papers by Helena Jagodic
DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 1987
European Neuropsychopharmacology, 2012
Additional file 1. Web appendix.
Psychiatria Danubina, 2012
Suicidal behaviour is a significant public health problem. Suicide alone represents the 10th lead... more Suicidal behaviour is a significant public health problem. Suicide alone represents the 10th leading cause of death worldwide. Suicide is a complex phenomenon and may be the result of an interaction of biological, psychological and socioeconomic factors. Although there are many differences in suicide rates between different countries in the world, some studies reported huge differences of suicide rates between different regions within the same country as well. The studies that investigated the regional differences in suicide rates were gathered in the present article. The studies revealed that depression frequently remained unidentified and thus untreated and could contribute to high regional suicide rates. It could be speculated that access to services, which increases the possibility of diagnosis and treatment of mental disorders, could have an impact on regional suicide rates. Thus the availability of services may be relevant in explaining geographical variations in suicide incid...
The British journal of psychiatry : the journal of mental science, 2014
It is unclear whether there is a direct link between economic crises and changes in suicide rates... more It is unclear whether there is a direct link between economic crises and changes in suicide rates. The Lopez-Ibor Foundation launched an initiative to study the possible impact of the economic crisis on European suicide rates. Data was gathered and analysed from 29 European countries and included the number of deaths by suicide in men and women, the unemployment rate, the gross domestic product (GDP) per capita, the annual economic growth rate and inflation. There was a strong correlation between suicide rates and all economic indices except GPD per capita in men but only a correlation with unemployment in women. However, the increase in suicide rates occurred several months before the economic crisis emerged. Overall, this study confirms a general relationship between the economic environment and suicide rates; however, it does not support there being a clear causal relationship between the current economic crisis and an increase in the suicide rate.
Slovenian Medical Journal, 2011
Background: Electroconvulsive therapy (ECT) dates back to the beginning of biologic psychiatry. P... more Background: Electroconvulsive therapy (ECT) dates back to the beginning of biologic psychiatry. Particularly, the introduction of general anesthesia and muscle relaxation as well as recent advances in ECT technique greatly reduced the incidence of complications related with ECT and post- interventional adverse cognitive effects. Today, ECT is still the most effective acute antidepressant treatment. In most countries ECT is used for the treatment of severe depression that failed to respond to psychopharmacotherapy and other therapy. Because ECT provides a fast response, it is specially recommended for lifethreatening illness conditions including agitation, stupor, food restriction or high suicide risk. Conclusions: Within the profession up-todate ECT is considered safe, effective and rapid working treatment for the severest forms of mental disorders. On the contrary, ECT is not performed in Slovenia. No professional reason exists that ECT would not be available in Slovenia. By Sloven...
Suicidal behaviour has multiple causes. Psychiatric disorder is a major contributing factor. Cons... more Suicidal behaviour has multiple causes. Psychiatric disorder is a major contributing factor. Consecutively, diagnosis and treatment of mental disorders has an impact on suicide rate. The studies that investigated the possible impact of psychopharmacotherapy prescription practise on suicide rate have been gathered in the present article. Ongoing discussion of potential benefits and risks of antidepressant treatment with respect to suicidal behaviours includes many ecological, or population- based, correlational studies of temporal or regional trends in suicide rates and rates of usage of modern antidepressants including SSRIs. A number of studies have found a relationship between increase in national antidepressant prescribing and declining suicide rates, with general agreement but some exceptions. In general, studies showed that increased prescribing of antidepressants may indicate improved diagnosis and treatment of depression. On the other hand, studies that investigated the impac...
Slovenian Medical Journal, 2009
Background Delirium is defined as an impairment of counsciousness and cognitive functions and is ... more Background Delirium is defined as an impairment of counsciousness and cognitive functions and is a common cause of disturbed behaviour in many patients with different somatic diseases and mental disorders. Most at risk are elderly, postoperative patients, critically ill patients and those with cancer in advanced stages. In psychiatric intensive care units patients with alcohol and sedative withdrawal related delirium are more often treated. Although delirium is a negative prognostic indicator leading to higher morbidity and mortality of patients, it often goes undetected and poorly managed. Conclusions Most recommendations for management of delirium are based on the nonpharmacological supportive care and prevention of delirium. It is also necessary to identify and treat the underlying causes. Antipsychotics are the mainstay of symptomatic pharmacological treatment and have been shown to be effective in treating symptoms of both hyperactive and hypoactive delirium. Although efficacy ...
Critical Care, 2006
Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II ce... more Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II cells (A549). To study in vitro the direct influence of alveolar type II cells on mechanical stretch. Methods A549 were treated with different doses of lipopolysaccharide (LPS), 0 ng/ml, 1 ng/ml, 10 ng/ml, 100 ng/ml, 1000 ng/ml, and then A549 were lengthened 5%, 15%, 30% using a FLEXCELL tension unit 4000, a vacuum-driven device that applies strain to cells, which were cultured in six-well plates coated with collagen-I, and 12 cycles/min for 4 hours. Apoptosis was measured using the flow cytometry method that measures annexin V and propidium iodide (PI) staining. The morphological changes of apoptotic cells were observed by transmission electron microscope. Results Apoptosis could be induced in alveolar type II cells (A549) by mechanical stretch. The percentage of annexin V + PI cells increased after being treated with cyclic stretch for 4 hours by 5%, 15%, 30% in all groups. The morphological features of apoptotic cells demonstrated by transmission electron microscope were as follows: shrinkage of the cell, chromatin condensation and aggregation under the nuclear membrane as a crescent or lump, membrane-encapsulated nuclear fragment or cell organ formed by invagination of the cell membrane, and apoptotic body formation followed by vacuolization. Conclusion Apoptosis induced by mechanical stretch and LPS is dose dependent. Mechanical stretch aggravates apoptosis especially in cells treated with LPS. Annexin V and PI double staining is a specific, sensitive, and quantitative method for analyzing apoptotic cells. It is also helpful to clarify the protective mechanism of low-volume ventilation in ARDS. Acknowledgement The study was funded by the 'One Hundred People' project of Shanghai Sanitary Bureau (03-77-20).
Annals of general psychiatry, 2016
It is well known that suicidal rates vary considerably among European countries and the reasons f... more It is well known that suicidal rates vary considerably among European countries and the reasons for this are unknown, although several theories have been proposed. The effect of economic variables has been extensively studied but not that of climate. Data from 29 European countries covering the years 2000-2012 and concerning male and female standardized suicidal rates (according to WHO), economic variables (according World Bank) and climate variables were gathered. The statistical analysis included cluster and principal component analysis and categorical regression. The derived models explained 62.4 % of the variability of male suicidal rates. Economic variables alone explained 26.9 % and climate variables 37.6 %. For females, the respective figures were 41.7, 11.5 and 28.1 %. Male suicides correlated with high unemployment rate in the frame of high growth rate and high inflation and low GDP per capita, while female suicides correlated negatively with inflation. Both male and female...
Slovenian Medical Journal, Jan 12, 2008
Izvleček Izhodišča Ledvična kolika je eden izmed najpogostejših vzrokov za nujno urološko obravna... more Izvleček Izhodišča Ledvična kolika je eden izmed najpogostejših vzrokov za nujno urološko obravnavo. Do spontane izločitve kamnov v spodnjem delu sečevoda pride največkrat s pomočjo dobre hidracije in s spazmo-analgetičnim zdravljenjem. Uporaba blokatorjev α-adrenergičnih receptorjev naj bi povečala delež spontanih izločitev kamnov iz sečevoda.
Slovenian Medical Journal, Jan 3, 2011
Izhodišča: Elektrokonvulzivna terapija (EKT) predstavlja enega od začetkov biološke psihiatrije. ... more Izhodišča: Elektrokonvulzivna terapija (EKT) predstavlja enega od začetkov biološke psihiatrije. Z uvedbo splošne anestezije in mišične relaksacije ter izpopolnjene tehnike izvajanja EKT se je zmanjšalo število zapletov zaradi EKT kot tudi neželenih vplivov na spoznavne sposobnosti pri bolnikih. Danes še vedno velja, da je EKT najučinkovitejše akutno antidepresivno zdravljenje. V tujini ga najpogosteje uporabljajo za zdravljenje hudih oblik depresije pri bolnikih, pri katerih so izčrpali možnosti zdravljenja, zlasti psihofarmakoterapevtskega. Ker EKT učinkuje hitro, jo posebno priporočajo v stanjih, ki ogrožajo življenje, kot so agitacija, stupor, huda telesna izčrpanost zaradi odklanjanja hrane in visoko tveganje za samomor. Zaključki: Strokovna literatura uvršča sodobno izvajanje EKT med varne, hitre in učinkovite metode zdravljenja določenih, za človeka najbolj ogrožajočih oblik psihičnih motenj. V Sloveniji zdravljenja z EKT ne izvajamo. Ni strokovnih razlogov, da tovrstno zdravljenje ne bi bilo na voljo tudi v Sloveniji. Različne ovire trenutno omejujejo dostopnost tovrstnega načina zdravljenja, zlasti pri bolnikih v akutnih stanjih, kljub temu da zakon o duševnem zdravju izrecno omenja EKT in jo uvršča med posebne metode zdravljenja psihičnih motenj.
Slovenian Medical Journal, Jan 9, 2009
Izvleček Izhodišča Delirij je stanje skaljene zavesti in izrazitih motenj spoznavnih sposobnosti ... more Izvleček Izhodišča Delirij je stanje skaljene zavesti in izrazitih motenj spoznavnih sposobnosti ter je pogost vzrok nemirnega vedenja pri bolnikih z različnimi telesnimi boleznimi in duševnimi motnjami. Posebno so ogroženi starejši, bolniki po operativnih posegih, kritično bolni na intenzivnih oddelkih ter bolniki z napredovalimi oblikami onkoloških bolezni. Na psihiatičnih intenzivnih enotah se pogosteje zdravijo bolniki z delirijem, ki nastane kot posledica odtegnitve od alkohola ali sedativov. Delirij pomembno zvišuje obolevnost in umrljivost bolnikov, kljub temu pa še vedno ostaja pogosto neprepoznan in nezdravljen. Zaključki Pri obravnavi bolnikov je pomembno izvajati vse nefarmakološke in ostale podporne ukrepe za preprečevanje nastanka delirija. Potrebno je prepoznati delirij, ko ta nastane, in prepoznati vzroke za nastanek ter jih ustrezno odpraviti. Mogoče je tudi simptomatsko zdravljenje delirija z antipsihotiki, ki so primerni za zdravljenje tako hiperaktivne kot hipoaktivne oblike delirija. Raziskave so pokazale, da je učinek atipičnih in klasičnih antipsihotikov primerljiv, le da imajo atipični manj ekstrapiramidnih neželenih učinkov. Raziskave kažejo na učinkovitost benzodiazepinov predvsem pri zdravljenju delirija zaradi odtegnitve od alkohola ali benzodiazepinov ter kot dodatek k antipsihotikom, ko so le-ti neučinkoviti ali povzročajo neželene učinke.
Psychiatria Danubina, 2013
Suicidal behaviour has multiple causes. Psychiatric disorder is a major contributing factor. Cons... more Suicidal behaviour has multiple causes. Psychiatric disorder is a major contributing factor. Consecutively, diagnosis and treatment of mental disorders has an impact on suicide rate. The studies that investigated the possible impact of psychopharmacotherapy prescription practise on suicide rate have been gathered in the present article. Ongoing discussion of potential benefits and risks of antidepressant treatment with respect to suicidal behaviours includes many ecological, or population- based, correlational studies of temporal or regional trends in suicide rates and rates of usage of modern antidepressants including SSRIs. A number of studies have found a relationship between increase in national antidepressant prescribing and declining suicide rates, with general agreement but some exceptions. In general, studies showed that increased prescribing of antidepressants may indicate improved diagnosis and treatment of depression. On the other hand, studies that investigated the impac...
Psychiatria Danubina, 2012
Suicidal behaviour is a significant public health problem. Suicide alone represents the 10th lead... more Suicidal behaviour is a significant public health problem. Suicide alone represents the 10th leading cause of death worldwide. Suicide is a complex phenomenon and may be the result of an interaction of biological, psychological and socioeconomic factors. Although there are many differences in suicide rates between different countries in the world, some studies reported huge differences of suicide rates between different regions within the same country as well. The studies that investigated the regional differences in suicide rates were gathered in the present article. The studies revealed that depression frequently remained unidentified and thus untreated and could contribute to high regional suicide rates. It could be speculated that access to services, which increases the possibility of diagnosis and treatment of mental disorders, could have an impact on regional suicide rates. Thus the availability of services may be relevant in explaining geographical variations in suicide incid...
Prostate Cancer and Prostatic Diseases, 2009
Investigator-derived quality of life (QoL) instruments such as the Functional Assessment of Cance... more Investigator-derived quality of life (QoL) instruments such as the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire do not allow participants to weight the relative importance of QoL domains. We investigated the effect of allowing patients the ability to weight the relative importance of the five areas included in the FACT-P (Physical, Social, Emotional and Functional well-being, and Additional concerns). Patients (n ¼ 150) completed the FACT-P and gauged the relative importance of each QoL domain using a direct-weighting approach. This was then used to provide an adjusted Hybrid QoL score. Patients also completed a Visual Analogue Scale. Patients considered Social well-being to be the most important domain and Additional concerns to be the least important. When patient weightings were taken into account overall QoL scores increased. The validity of the Hybrid score was supported by its ability to distinguish between patients with metastatic and locoregional disease and its ability to detect expected decreases in global QoL over time. Application of the direct-weighting approach to the FACT-P allows assessments to more accurately reflect individual QoL. Unadjusted QoL scores may lead researchers to incorrectly estimate the true QoL of respondents.
Journal of Medical Case Reports, 2007
Penile fracture is a rare condition. Primarily it is a rupture of the corpus cavernosum that occu... more Penile fracture is a rare condition. Primarily it is a rupture of the corpus cavernosum that occurs when the penis is erect. The rupture can also affect the corpus spongiosum and the urethra. We report a case of a 37 year old man who presented with acute penile pain, penile swelling and the inability to pass urine after a blunt trauma during sexual intercourse. In emergency surgery we found bilateral partial rupture of the corpus cavernosum with complete urethral and corpus spongiosum disruption. In the one year follow up the patient presented with normal erectile and voiding function. Emergency surgical repair in penile fracture can preserve erectile and voiding function.
European Neuropsychopharmacology, 2008
Critical Care, 2006
Our aim was to determine long-term survival and quality of life of patients admitted to a surgica... more Our aim was to determine long-term survival and quality of life of patients admitted to a surgical intensive care unit (ICU) because of sepsis or trauma. This was an observational study conducted in an 11-bed, closed surgical ICU at a 860-bed teaching general hospital over a 1-year period (January 2003 to December 2003). Patients were divided into two groups according to admission diagnoses: group 1 included patients with sepsis; and group 2 included patients with trauma (polytrauma, multiple trauma, head injury, or spinal injury). Quality of life was assessed after 2 years following ICU admission using the EuroQol 5D questionnaire. A total of 164 patients (98 trauma patients and 66 patients with sepsis) were included in the study. Trauma patients were younger than patients with sepsis (53 +/- 21 years versus 64 +/- 13 years; P < or = 0.001). There was no significant difference between groups in Acute Physiology and Chronic Health Evaluation II score or length of stay in the surgical SICU. Trauma patients stayed longer on the general ward (35 +/- 44 days versus 17 +/- 24 days; P < 001). Surgical ICU survival, in-hospital survival, and post-hospital and cumulative 2-year survival were lower in the sepsis group than in the trauma group (surgical ICU survival: 60% versus 74%; in-hospital survival: 42% versus 62%; post-hospital survival: 78% versus 92%; cumulative 2-year survival: 33% versus 57%; P < 0.05). There was no significant difference in quality of life in all five dimensions of the EuroQol 5D between groups: 60% of patients had signs of depression, almost 60% had problems in usual activities and 56% had pain. Patients with sepsis treated in a surgical ICU have higher short-term and long-term mortality than do trauma patients. However, quality of life is reduced to the same level in both groups.
DOAJ (DOAJ: Directory of Open Access Journals), Jun 1, 1987
European Neuropsychopharmacology, 2012
Additional file 1. Web appendix.
Psychiatria Danubina, 2012
Suicidal behaviour is a significant public health problem. Suicide alone represents the 10th lead... more Suicidal behaviour is a significant public health problem. Suicide alone represents the 10th leading cause of death worldwide. Suicide is a complex phenomenon and may be the result of an interaction of biological, psychological and socioeconomic factors. Although there are many differences in suicide rates between different countries in the world, some studies reported huge differences of suicide rates between different regions within the same country as well. The studies that investigated the regional differences in suicide rates were gathered in the present article. The studies revealed that depression frequently remained unidentified and thus untreated and could contribute to high regional suicide rates. It could be speculated that access to services, which increases the possibility of diagnosis and treatment of mental disorders, could have an impact on regional suicide rates. Thus the availability of services may be relevant in explaining geographical variations in suicide incid...
The British journal of psychiatry : the journal of mental science, 2014
It is unclear whether there is a direct link between economic crises and changes in suicide rates... more It is unclear whether there is a direct link between economic crises and changes in suicide rates. The Lopez-Ibor Foundation launched an initiative to study the possible impact of the economic crisis on European suicide rates. Data was gathered and analysed from 29 European countries and included the number of deaths by suicide in men and women, the unemployment rate, the gross domestic product (GDP) per capita, the annual economic growth rate and inflation. There was a strong correlation between suicide rates and all economic indices except GPD per capita in men but only a correlation with unemployment in women. However, the increase in suicide rates occurred several months before the economic crisis emerged. Overall, this study confirms a general relationship between the economic environment and suicide rates; however, it does not support there being a clear causal relationship between the current economic crisis and an increase in the suicide rate.
Slovenian Medical Journal, 2011
Background: Electroconvulsive therapy (ECT) dates back to the beginning of biologic psychiatry. P... more Background: Electroconvulsive therapy (ECT) dates back to the beginning of biologic psychiatry. Particularly, the introduction of general anesthesia and muscle relaxation as well as recent advances in ECT technique greatly reduced the incidence of complications related with ECT and post- interventional adverse cognitive effects. Today, ECT is still the most effective acute antidepressant treatment. In most countries ECT is used for the treatment of severe depression that failed to respond to psychopharmacotherapy and other therapy. Because ECT provides a fast response, it is specially recommended for lifethreatening illness conditions including agitation, stupor, food restriction or high suicide risk. Conclusions: Within the profession up-todate ECT is considered safe, effective and rapid working treatment for the severest forms of mental disorders. On the contrary, ECT is not performed in Slovenia. No professional reason exists that ECT would not be available in Slovenia. By Sloven...
Suicidal behaviour has multiple causes. Psychiatric disorder is a major contributing factor. Cons... more Suicidal behaviour has multiple causes. Psychiatric disorder is a major contributing factor. Consecutively, diagnosis and treatment of mental disorders has an impact on suicide rate. The studies that investigated the possible impact of psychopharmacotherapy prescription practise on suicide rate have been gathered in the present article. Ongoing discussion of potential benefits and risks of antidepressant treatment with respect to suicidal behaviours includes many ecological, or population- based, correlational studies of temporal or regional trends in suicide rates and rates of usage of modern antidepressants including SSRIs. A number of studies have found a relationship between increase in national antidepressant prescribing and declining suicide rates, with general agreement but some exceptions. In general, studies showed that increased prescribing of antidepressants may indicate improved diagnosis and treatment of depression. On the other hand, studies that investigated the impac...
Slovenian Medical Journal, 2009
Background Delirium is defined as an impairment of counsciousness and cognitive functions and is ... more Background Delirium is defined as an impairment of counsciousness and cognitive functions and is a common cause of disturbed behaviour in many patients with different somatic diseases and mental disorders. Most at risk are elderly, postoperative patients, critically ill patients and those with cancer in advanced stages. In psychiatric intensive care units patients with alcohol and sedative withdrawal related delirium are more often treated. Although delirium is a negative prognostic indicator leading to higher morbidity and mortality of patients, it often goes undetected and poorly managed. Conclusions Most recommendations for management of delirium are based on the nonpharmacological supportive care and prevention of delirium. It is also necessary to identify and treat the underlying causes. Antipsychotics are the mainstay of symptomatic pharmacological treatment and have been shown to be effective in treating symptoms of both hyperactive and hypoactive delirium. Although efficacy ...
Critical Care, 2006
Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II ce... more Objective To examine the effects of short-term cyclic stretch on apoptosis in alveolar type II cells (A549). To study in vitro the direct influence of alveolar type II cells on mechanical stretch. Methods A549 were treated with different doses of lipopolysaccharide (LPS), 0 ng/ml, 1 ng/ml, 10 ng/ml, 100 ng/ml, 1000 ng/ml, and then A549 were lengthened 5%, 15%, 30% using a FLEXCELL tension unit 4000, a vacuum-driven device that applies strain to cells, which were cultured in six-well plates coated with collagen-I, and 12 cycles/min for 4 hours. Apoptosis was measured using the flow cytometry method that measures annexin V and propidium iodide (PI) staining. The morphological changes of apoptotic cells were observed by transmission electron microscope. Results Apoptosis could be induced in alveolar type II cells (A549) by mechanical stretch. The percentage of annexin V + PI cells increased after being treated with cyclic stretch for 4 hours by 5%, 15%, 30% in all groups. The morphological features of apoptotic cells demonstrated by transmission electron microscope were as follows: shrinkage of the cell, chromatin condensation and aggregation under the nuclear membrane as a crescent or lump, membrane-encapsulated nuclear fragment or cell organ formed by invagination of the cell membrane, and apoptotic body formation followed by vacuolization. Conclusion Apoptosis induced by mechanical stretch and LPS is dose dependent. Mechanical stretch aggravates apoptosis especially in cells treated with LPS. Annexin V and PI double staining is a specific, sensitive, and quantitative method for analyzing apoptotic cells. It is also helpful to clarify the protective mechanism of low-volume ventilation in ARDS. Acknowledgement The study was funded by the 'One Hundred People' project of Shanghai Sanitary Bureau (03-77-20).
Annals of general psychiatry, 2016
It is well known that suicidal rates vary considerably among European countries and the reasons f... more It is well known that suicidal rates vary considerably among European countries and the reasons for this are unknown, although several theories have been proposed. The effect of economic variables has been extensively studied but not that of climate. Data from 29 European countries covering the years 2000-2012 and concerning male and female standardized suicidal rates (according to WHO), economic variables (according World Bank) and climate variables were gathered. The statistical analysis included cluster and principal component analysis and categorical regression. The derived models explained 62.4 % of the variability of male suicidal rates. Economic variables alone explained 26.9 % and climate variables 37.6 %. For females, the respective figures were 41.7, 11.5 and 28.1 %. Male suicides correlated with high unemployment rate in the frame of high growth rate and high inflation and low GDP per capita, while female suicides correlated negatively with inflation. Both male and female...
Slovenian Medical Journal, Jan 12, 2008
Izvleček Izhodišča Ledvična kolika je eden izmed najpogostejših vzrokov za nujno urološko obravna... more Izvleček Izhodišča Ledvična kolika je eden izmed najpogostejših vzrokov za nujno urološko obravnavo. Do spontane izločitve kamnov v spodnjem delu sečevoda pride največkrat s pomočjo dobre hidracije in s spazmo-analgetičnim zdravljenjem. Uporaba blokatorjev α-adrenergičnih receptorjev naj bi povečala delež spontanih izločitev kamnov iz sečevoda.
Slovenian Medical Journal, Jan 3, 2011
Izhodišča: Elektrokonvulzivna terapija (EKT) predstavlja enega od začetkov biološke psihiatrije. ... more Izhodišča: Elektrokonvulzivna terapija (EKT) predstavlja enega od začetkov biološke psihiatrije. Z uvedbo splošne anestezije in mišične relaksacije ter izpopolnjene tehnike izvajanja EKT se je zmanjšalo število zapletov zaradi EKT kot tudi neželenih vplivov na spoznavne sposobnosti pri bolnikih. Danes še vedno velja, da je EKT najučinkovitejše akutno antidepresivno zdravljenje. V tujini ga najpogosteje uporabljajo za zdravljenje hudih oblik depresije pri bolnikih, pri katerih so izčrpali možnosti zdravljenja, zlasti psihofarmakoterapevtskega. Ker EKT učinkuje hitro, jo posebno priporočajo v stanjih, ki ogrožajo življenje, kot so agitacija, stupor, huda telesna izčrpanost zaradi odklanjanja hrane in visoko tveganje za samomor. Zaključki: Strokovna literatura uvršča sodobno izvajanje EKT med varne, hitre in učinkovite metode zdravljenja določenih, za človeka najbolj ogrožajočih oblik psihičnih motenj. V Sloveniji zdravljenja z EKT ne izvajamo. Ni strokovnih razlogov, da tovrstno zdravljenje ne bi bilo na voljo tudi v Sloveniji. Različne ovire trenutno omejujejo dostopnost tovrstnega načina zdravljenja, zlasti pri bolnikih v akutnih stanjih, kljub temu da zakon o duševnem zdravju izrecno omenja EKT in jo uvršča med posebne metode zdravljenja psihičnih motenj.
Slovenian Medical Journal, Jan 9, 2009
Izvleček Izhodišča Delirij je stanje skaljene zavesti in izrazitih motenj spoznavnih sposobnosti ... more Izvleček Izhodišča Delirij je stanje skaljene zavesti in izrazitih motenj spoznavnih sposobnosti ter je pogost vzrok nemirnega vedenja pri bolnikih z različnimi telesnimi boleznimi in duševnimi motnjami. Posebno so ogroženi starejši, bolniki po operativnih posegih, kritično bolni na intenzivnih oddelkih ter bolniki z napredovalimi oblikami onkoloških bolezni. Na psihiatičnih intenzivnih enotah se pogosteje zdravijo bolniki z delirijem, ki nastane kot posledica odtegnitve od alkohola ali sedativov. Delirij pomembno zvišuje obolevnost in umrljivost bolnikov, kljub temu pa še vedno ostaja pogosto neprepoznan in nezdravljen. Zaključki Pri obravnavi bolnikov je pomembno izvajati vse nefarmakološke in ostale podporne ukrepe za preprečevanje nastanka delirija. Potrebno je prepoznati delirij, ko ta nastane, in prepoznati vzroke za nastanek ter jih ustrezno odpraviti. Mogoče je tudi simptomatsko zdravljenje delirija z antipsihotiki, ki so primerni za zdravljenje tako hiperaktivne kot hipoaktivne oblike delirija. Raziskave so pokazale, da je učinek atipičnih in klasičnih antipsihotikov primerljiv, le da imajo atipični manj ekstrapiramidnih neželenih učinkov. Raziskave kažejo na učinkovitost benzodiazepinov predvsem pri zdravljenju delirija zaradi odtegnitve od alkohola ali benzodiazepinov ter kot dodatek k antipsihotikom, ko so le-ti neučinkoviti ali povzročajo neželene učinke.
Psychiatria Danubina, 2013
Suicidal behaviour has multiple causes. Psychiatric disorder is a major contributing factor. Cons... more Suicidal behaviour has multiple causes. Psychiatric disorder is a major contributing factor. Consecutively, diagnosis and treatment of mental disorders has an impact on suicide rate. The studies that investigated the possible impact of psychopharmacotherapy prescription practise on suicide rate have been gathered in the present article. Ongoing discussion of potential benefits and risks of antidepressant treatment with respect to suicidal behaviours includes many ecological, or population- based, correlational studies of temporal or regional trends in suicide rates and rates of usage of modern antidepressants including SSRIs. A number of studies have found a relationship between increase in national antidepressant prescribing and declining suicide rates, with general agreement but some exceptions. In general, studies showed that increased prescribing of antidepressants may indicate improved diagnosis and treatment of depression. On the other hand, studies that investigated the impac...
Psychiatria Danubina, 2012
Suicidal behaviour is a significant public health problem. Suicide alone represents the 10th lead... more Suicidal behaviour is a significant public health problem. Suicide alone represents the 10th leading cause of death worldwide. Suicide is a complex phenomenon and may be the result of an interaction of biological, psychological and socioeconomic factors. Although there are many differences in suicide rates between different countries in the world, some studies reported huge differences of suicide rates between different regions within the same country as well. The studies that investigated the regional differences in suicide rates were gathered in the present article. The studies revealed that depression frequently remained unidentified and thus untreated and could contribute to high regional suicide rates. It could be speculated that access to services, which increases the possibility of diagnosis and treatment of mental disorders, could have an impact on regional suicide rates. Thus the availability of services may be relevant in explaining geographical variations in suicide incid...
Prostate Cancer and Prostatic Diseases, 2009
Investigator-derived quality of life (QoL) instruments such as the Functional Assessment of Cance... more Investigator-derived quality of life (QoL) instruments such as the Functional Assessment of Cancer Therapy-Prostate (FACT-P) questionnaire do not allow participants to weight the relative importance of QoL domains. We investigated the effect of allowing patients the ability to weight the relative importance of the five areas included in the FACT-P (Physical, Social, Emotional and Functional well-being, and Additional concerns). Patients (n ¼ 150) completed the FACT-P and gauged the relative importance of each QoL domain using a direct-weighting approach. This was then used to provide an adjusted Hybrid QoL score. Patients also completed a Visual Analogue Scale. Patients considered Social well-being to be the most important domain and Additional concerns to be the least important. When patient weightings were taken into account overall QoL scores increased. The validity of the Hybrid score was supported by its ability to distinguish between patients with metastatic and locoregional disease and its ability to detect expected decreases in global QoL over time. Application of the direct-weighting approach to the FACT-P allows assessments to more accurately reflect individual QoL. Unadjusted QoL scores may lead researchers to incorrectly estimate the true QoL of respondents.
Journal of Medical Case Reports, 2007
Penile fracture is a rare condition. Primarily it is a rupture of the corpus cavernosum that occu... more Penile fracture is a rare condition. Primarily it is a rupture of the corpus cavernosum that occurs when the penis is erect. The rupture can also affect the corpus spongiosum and the urethra. We report a case of a 37 year old man who presented with acute penile pain, penile swelling and the inability to pass urine after a blunt trauma during sexual intercourse. In emergency surgery we found bilateral partial rupture of the corpus cavernosum with complete urethral and corpus spongiosum disruption. In the one year follow up the patient presented with normal erectile and voiding function. Emergency surgical repair in penile fracture can preserve erectile and voiding function.
European Neuropsychopharmacology, 2008
Critical Care, 2006
Our aim was to determine long-term survival and quality of life of patients admitted to a surgica... more Our aim was to determine long-term survival and quality of life of patients admitted to a surgical intensive care unit (ICU) because of sepsis or trauma. This was an observational study conducted in an 11-bed, closed surgical ICU at a 860-bed teaching general hospital over a 1-year period (January 2003 to December 2003). Patients were divided into two groups according to admission diagnoses: group 1 included patients with sepsis; and group 2 included patients with trauma (polytrauma, multiple trauma, head injury, or spinal injury). Quality of life was assessed after 2 years following ICU admission using the EuroQol 5D questionnaire. A total of 164 patients (98 trauma patients and 66 patients with sepsis) were included in the study. Trauma patients were younger than patients with sepsis (53 +/- 21 years versus 64 +/- 13 years; P < or = 0.001). There was no significant difference between groups in Acute Physiology and Chronic Health Evaluation II score or length of stay in the surgical SICU. Trauma patients stayed longer on the general ward (35 +/- 44 days versus 17 +/- 24 days; P < 001). Surgical ICU survival, in-hospital survival, and post-hospital and cumulative 2-year survival were lower in the sepsis group than in the trauma group (surgical ICU survival: 60% versus 74%; in-hospital survival: 42% versus 62%; post-hospital survival: 78% versus 92%; cumulative 2-year survival: 33% versus 57%; P < 0.05). There was no significant difference in quality of life in all five dimensions of the EuroQol 5D between groups: 60% of patients had signs of depression, almost 60% had problems in usual activities and 56% had pain. Patients with sepsis treated in a surgical ICU have higher short-term and long-term mortality than do trauma patients. However, quality of life is reduced to the same level in both groups.