Dubravka Kalinić

Oxidative status and the severity of clinical symptoms in patients with post-traumatic stress disorder

Background The aim of this study was to measure the parameters of oxidative stress in the blood of patients with post-traumatic stress disorder. Methods The study included 80 male war veterans who participated actively in the Homeland war in Croatia. Volunteers were divided into two groups: 50 veterans diagnosed with post-traumatic stress disorder and 30 without diagnosis. The self-assessment Hospital Anxiety and Depression Scale and the Beck Depression Inventory were used to detect the severity of depression and anxiety in the post-traumatic stress disorder patients. Catalytic concentrations of superoxide dismutase and glutathione peroxidase in erythrocytes and the concentration of malondialdehyde in serum were measured spectrophotometrically. Results Although the catalytic concentrations of erythrocyte superoxide dismutase and erythrocyte glutathione peroxidase were within the reference range for both groups, the values obtained for the post-traumatic stress disorder group were significantly lower (P < 0.001). For serum malondialdehyde concentrations, no statistically significant differences between the groups were found. Conclusions Lower catalytic concentrations of erythrocyte superoxide dismutase and erythrocyte glutathione peroxidase in patients with post-traumatic stress disorder may indicate a weaker response to oxidative stress due to impaired enzyme activity and/or decreased synthesis. Conversely, no significant changes in serum malondialdehyde concentrations suggest a compensated balance and adaptive response to (oxidative) stress.

The problem of informed consent of persons with neurocognitive disorders in clinical investigations

Podatci s pocetka milenija ukazivali su na prevalenciju Alzheimerove bolesti od 24, 3 milijuna oboljelih u svijetu, ali i na ocekivani znacajni godisnji porast broja novih slucajeva demencije, koji sada iznosi vec 4, 6 milijuna. Sto se tice najnovijih globalnih procjena možemo se osloniti na procjenu ADI-a (Alzheimer Disease International), krovne udruge koja okuplja 80 nacionalnih Alzheimer organizacija, iz koje je razvidno da danas u svijetu ima vise od 47 milijuna osoba s demencijom. No, zabrinjava tvrdnja da ce broj oboljelih i nadalje progresivno rasti. Biomedicinska istraživanja su neprocjenjiv (i jedini) izvor novih spoznaja i znanja zahvaljujuci kojima je postignut znacajan napredak u podrucju medicine u proslom stoljecu (a sto traje i danas). U podrucju klinickih istraživanja osobe s demencijom su vulnerabilna skupina. Zakonska odredba prema kojoj se onemogucava davanje pristanka za sudjelovanje u istraživanjima od strane zakonskog zastupnika je potencijalno ogranicavajuci faktor u kontekstu istraživanja koja ukljucuju osobe s demencijom. U podrucju psihijatrije nužna je procjena pacijentove sposobnosti za davanje informiranog pristanka. S obzirom na specificnosti mentalnih poremecaja ova procjena je nužna u cilju zastite bolesnika i njegova prava na izbor medicinskog postupka kao i u cilju izbjegavanja zloporaba u svakodnevnoj klinickoj praksi. / From the beginning of the millennium showed that the prevalence of Alzheimers disease was at 24.3 million of patients globally, but also anticipated a significant increase of the number of new cases of dementia, which are currently at 4.6 million. Currently, based on estimates from the ADI (Alzheimer Disease International), a head association that aggregates data 80 national Alzheimer organizations, it is apparent that there are more than 47 million persons with dementia in the world today. However, what is concerning is the statement that this number will continue to grow progressively. Biomedical investigations are an invaluable (and the only) source of new knowledge, thanks to which significant progress has been achieved in medicine during previous century and continues to be achieved today. ln the field of clinical investigations, persons with dementia represent a vulnerable group. The legal representative of the person with dementia cannot give consent for participation in clinical investigation, which represents a potentially limiting factor for clinical investigations that include persons with dementia. In psychiatry, the evaluation of patient competence for giving informed consent is necessary. Given the specificity of mental disorders, this evaluation is necessary in order to protect the patient and their choice of medical procedure as well as to avoid misuse in everyday clinical practice.