Browsing by Author "Dimitrijević, Ivan (57207504419)"

Introduction/Objective Alcohol abuse influence on developing thyroid cancer is controversial. While some studies consider it a protective factor, others deny any impact on thyroid cancer. The objective of the paper was to establish a possible link between alcohol abuse and certain types of thyroid cancers. Methods The retrospective study included 502 patients with thyroid cancer and a control group of 600 patients with benign forms of thyroid diseases (e.g. nodular, multinodular, and toxic nodular goiter). Thyroid cancer patients were divided into four groups: I – papillary, II – medullary, III – anaplastic, and IV – follicular carcinoma, and grouped by sex, age (< 30 years; > 30 years) and alcohol abuse, as defined by the World Health Organization. Results Thyroid cancer patients were predominantly male of younger age. This distribution difference was statistically significant in groups I and II (p < 0.001). Of total 10 (0.9%) patients with chronic alcohol abuse, eight (1.6%) had thyroid cancer, while two (0.3%) belonged to the control group (p < 0.001). In thyroid cancer patients, chronic alcohol abuse was absent from groups III and IV. Distribution in groups I and II was six (1.6%) and two (2%), respectively (p < 0.001). Conclusion Alcohol abuse deserves to be considered as a risk factor for papillary and medullary forms of thyroid cancer, while it does not stay the same for anaplastic and follicular thyroid cancers. © 2021, Serbia Medical Society. All rights reserved.

Background: Delirium is an urgent condition in psychiatry and it occurs after long-lasting alcohol abuse, in surgical procedures and other organic mental syndromes with deprivation of interpersonal and social stimulations. The aim was to evaluate of sociodemographical and psychopathological differences in delirium patients with alcoholand surgical genesis, studied in period from January 1st 2003 to December 31st 2012 in Bosnia and Herzegovina (B&H). Subjects and methods: Subjects were divided into two groups: alcoholics (N=75) and surgical patients (N=75) and multicentric, prospective study was performed in B&H. The following instruments have been used: list of general data (according to MCD-10 criteria), Eysenck Personality Questionnaire (EPQ), Becks test of anxiety (BAI), Hamilton Depressive Rating Scale (HDRS) and Mini Mental State Examination (MMSE). Descriptive and analytical statistical processing of patients has been performed (alpha level: 0.001). Results: Patients from alcohol group showed, with statistical significance p=0.001, the following: unemployment (OR=0.657, CI 0.540-670), ruined marriage (OR=0.570, CI 0.650-710), alcohol abuse (OR=0.179, CI 0.860-0.990), on represented expressed psychoticism, (OR=0.635, CI 0.550-0.715) in EPQ test, HDRS total was more frequent (OR=0.925, CI 0.870-1.120) and on MMSE test, total score was more frequent (OR=0.560, CI 0.570-810). Postoperative patients were older p=0.001 (OR= 1.120, CI 1.082-1.159) with acutestress: (OR=0.735, CI 0.650-0.910) and showed neuroticism (OR=-0.660, CI 0.575-0.715). Discriminative function confirms the differences between alcohol and surgical groups of delirium patients: Canonical Fcn: r=0.771; Wilkin's lambda (λnj)=0.773 Student's test=57.551 and significance p=0.001; OR=0.760, CI 0.550-0.870. Conclusion: Delirium lasts longer in alcohol group with higher disalienation, depression of cognitive functions with organic lesions of cerebral functions. In surgical patients, delirium is the consequence of older age, acute stress, multi-morbidity, with neuroticism, vegetative disorders (HDRS) and temporary lesion on MMSE test. Delirium state in both groups requires intensive care and multidisciplinary work. © Medicinska naklada.

Background: Studies imposing rigorous control over lifetime alcohol intake usually have not found smaller hippocampal volumes in persons with posttraumatic stress disorder (PTSD). Since the majority of negative studies have used adolescent samples, it has been suggested that chronicity is a necessary condition for such findings. We have hypothesized that the volumes of hippocampus, amygdale, prefrontal cortex and the intracranial volume are reduced in the patients with PTSD and excessive alcohol intake. Subjects and methods: Study has been carried out on 54 therapy naive PTSD suffering subjects and healthy controls, divided in two groups: 29 with PTSD and consequent alcoholism, 25 with PTSD but without problems of excessive alcohol intake, and 25 healthy volunteers. All of the patients underwent same magnetic resonance imaging (MRI) protocol and volumetric evaluation of the region of interest. Results: Only hippocampal volume appeared to be significantly reduced in patients with PTSD and alcoholism. Other differences in the volumes obtained remained to be insignificant. Conclusion: Alcohol intake definitely worsens the deterioration of the hippocampal formation in PTSD suffering patients. Nevertheless, other structures of interest for this study did not manifest any kind of statistical differences in volumetric analysis. © Medicinska naklada.

The association between cannabinoids and psychosis has been known for almost a thousand years, but it is still speculated whether cannabis use may be a contributory cause of psychosis, that is, whether it may precipitate schizophrenia in those at risk. In this paper, we will briefly present the data from individual longitudinal studies in the field, together with the factors that are considered important for the association of cannabis abuse and occurrence of schizophrenia and prevention opportunities in the target population. The reviewed studies clearly suggest that cannabis abuse predicts an increased risk for schizophrenia, particularly in young adults. They underline both the need to create adequate prevention measures and consequently avoid the occurrence of the disease in the young at risk. Particular attention should be additionally devoted toward encouraging the young presenting with psychotic symptoms to stop or, at the very least, reduce the frequency of cannabis abuse. The issues are undoubtedly to be addressed by the health care system in general. © Medicinska naklada.

This study analyses variables as predictors for both positive outcomes and dropout in undergoing inpatient treatment for alcohol use disorder (AUD). Retrospective in nature, it analyses patient treatment evaluations spanning a 25-year timeframe with a 5-year follow-up on positive outcomes. The sample consists of 820 inpatients who underwent AUD treatment. A set of 30 grouped variables was applied: socio-demographic data, clinical characteristics and therapy characteristics. Seventy-one percent successfully completed treatment. Six variables were defined as predictors of treatment outcome: education-level attained, employment, duration of alcohol dependence, abstinence upon admission to hospital, sponsor presence and use of disulfiram in treatment. The presence of sponsors and disulfiram in treatment are all net positives to successful treatment outcomes. Moreover, patients who have not achieved a minimum secondary school education are unemployed or at the onset of their alcohol addiction may require particular attention due to their higher risk of dropping out. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

In this article we summarized the recent research of the food addiction, diagnosis, treatment and prevention, which is carried out in this area. The concept of food addiction is new and complex, but proven to be very important for understanding and solving the problem of obesity. First part of this paper emphasizes the neurological studies, whose results indicate the similarity of brain processes that are being activated during drug abuse and during eating certain types of food. In this context, different authors speak of "hyper-palatable", industrial food, saturated with salt, fat and sugar, which favor an addiction. In the section on diagnostic and instruments constructed for assessing the degree of dependence, main diagnostic tool is standardized Yale Food Addiction Scale constructed by Ashley Gearhardt, and her associates. Since 2009, when it was first published, this scale is used in almost all researches in this area and has been translated into several languages. Finally, distinguish between prevention and treatment of food addiction was made. Given that there were similarities with other forms of addictive behavior, the researchers recommend the application of traditional addiction treatment. © Medicinska naklada.

The aim of our study was to investigate the expression of γ-catenin in normal kidney and in Wilms' tumor by immunohistochemistry and to correlate the results with tumor stage, histological type, and prognostic group. We investigated 28 cases of Wilms' tumor, 2 Wilms' tumor metastases in lungs, and 1 specimen of normal renal tissue. Expression of γ-catenin was detected in 14 cases. There was a weak inverse relationship between γ-catenin expression and tumor stage. Expression of γ-catenin was detected in various histologic types of Wilms' tumor, but there was no statistically significant correlation, except in cases with diffuse anaplasia that were negative. In 2 metastatic cases and in the case of bilateral Wilms' tumor γ-catenin immunostaining was not observed Our findings suggest an absence of strong correlation between the loss of γ-catenin and unfavorable outcome. Copyright © Informa Healthcare USA, Inc.

Introduction Alcoholism could represent an important factor of crime and different forms of abuse of family members (physical and emotional) exist in many alcohol-addict cases, as well as characteristics of immoral behaviour. Objective The objective of our study was to determine the predominating forms in moral judgment of alcohol addicts, and to examine whether there was any statistically significant difference in moral judgment between alcohol addicted persons and non-alcoholics from general population. Methods The sample consisted of 62 subjects, divided into a study (alcoholics) and a control group (non-alcoholics from general population). The following instruments were used: social-demographic data, AUDIT, MMPI-201, cybernetic battery of IQ tests (KOG-3) and the TMR moral reasoning test. Results Mature forms of moral judgment prevailed in both group of subjects, alcohol addicted persons and non-alcoholics. Regarding mature forms of moral judgment (driven by emotions and cognitive) non-alcoholics from the general population had higher scores, but the difference was not statistically significant. Regarding socially adapted and egocentric orientation alcohol addicted persons had higher scores. However, only regarding intuitive-irrational orientation there was a statistically significant difference in the level of moral judgment (p<0.05) between alcoholics and non-alcoholics, in favour of the alcoholics. Conclusion Moral judgment is not a category differing alcohol addicted persons from those who are not. Nevertheless, the potential destructivity of alcoholism is reflected in lower scores regarding mature orientations in moral judgment.

This review will examine the most important issues of preoperative evaluation and preparation in relation to patients with deseases affecting the central nervous system. Those patients may undergo various forms of surgery unrelated to the central nervous system disease. We discuss the effect of physiologic and pharmacological factors on cerebral autoregulation and control of intracranial pressure alongside its clinical relevance with the help of new evidence. Regardless of the reason for surgery, coexisting diseases of brain often have important implications when selecting anesthetic drugs, procedures and monitoring techniques. Suppression of cerebral metabolic rate is not the sole mechanism for the neuroprotective effect of anaesthetic agents. There are certain general principles, but also some specific circumstances, when we are talking about optimal anesthetic procedure for a patient with coexisting brain disease. Intravenous anesthesia, such as combination of propofol and remifentanil, provides best preservation of autoregulation. Among inhaled agents isoflurane and sevoflurane appear to preserve autoregulation at all doses, whereas with other agents autoregulation is impaired in a dose-related manner. During maintenance of anesthesia the patient is ventilated by intermittent positive pressure ventilation, at intermediate hyperventilation (PaCO2 25-30 mmHg). Intraoperative cerebral autoregulation monitoring is an important consideration for the patients with coexisting neurological disease. Transcranial Doppler based static autoregulation measurements appears to be the most robust bedside method for this purpose.

Ageing of populataion world wide has significant contribution as one of the major risk factor for neurodegenerative disorders. The patients with neurodegenerative as well as other neuological diseases presented the population with possible great need either of small or big surgical intervention. There are several important issues in patients with neurological diseases: the nature, disease duration, therapy, the patient's ability to live without assistance. Neurological disease may become worst by general and regional anesthesia. Stopping therapy may lead to worsening of neurological diseases. One of the main common threat is the risk of significant cardiorespiratory complications, which is important in assessing operational risk, in preoperative preparation and in terms of postoperative recovery and outcomes of surgical treatment. This has resulted in greater preoperative care by detailed patient history evaluation and examination, patient information and informed consent. Besides the effect of the anaesthetic technique upon the course of the disease, there is also the interaction of drugs administered during anaesthesia and patient medication. Several undiagnosed diseases may be disclosed following a surgical/anaesthetic intervention.

Proper diagnosis of psychoactive substance abuse and addiction, as well as acute intoxication, withdrawal syndrome and overdosing are of great importance in patients who are preparing for surgical intervention. There are some specific details in their preoperative preparation whether they underwent emergency or elective surgery. Good knowledge of the characteristics of psychoactive substance abuse and addiction, interaction of psychoactive substances and anesthetics and any other drugs that could be used in the perioperative period is important especially for anastesiologist. In this work we present key issues for recognizing theese patients as well as some guidelines for adequate preoperative preparation and postoperative care.

Pathological gambling was classified under impulse control disorders within the International Classification of Diseases (ICD-10) (WHO 1992), but the most recent Diagnostic and Statistical Manual, 5th edition (DSM-V), (APA 2013), has recognized pathological gambling as a first disorder within a new diagnostic category of behavioral addictions - Gambling disorder. Pathological gambling is a disorder in progression, and we hope that our experience in the treatment of pathological gambling in the Daily Hospital for Addictions at The Institute of Mental Health, through the original "Integrative - systemic model" would be of use to colleagues, dealing with this pathology. This model of treatment of pathological gambling is based on multi-systemic approach and it primarily represents an integration of family and cognitive-behavioral therapy, with traces of psychodynamic, existential and pharmacotherapy. The model is based on the book "Pathological gambling - with self-help manual" by Dr Mladenovic and Dr Lazetic, and has been designed in the form of a program that lasts 10 weeks in the intensive phase, and then continues for two years in the form of "extended treatment" ("After care"). The intensive phase is divided into three segments: educational, insight with initial changes and analysis of the achieved changes with the definition of plans and areas that need to be addressed in the extended treatment. "Extended treatment" lasts for two years in the form of group therapy, during which there is a second order change of the identified patient, but also of other family members. Pathological gambling has been treated in the form of systemic-family therapy for more than 10 years at the Institute of Mental Health (IMH), in Belgrade. For second year in a row the treatment is carried out by the modern "Integrative-systemic model". If abstinence from gambling witihin the period of one year after completion of the intensive phase of treatment is taken as the main criterion of the effectiveness of our model, at this time it exceeds 90%. Given the relatively short period of application, it is necessary to continue to monitor and evaluate the model after 5 years. © Medicinska naklada.