Gordana Nikolić

The influence of stress hyperglycaemia on the prognosis of patients with acute myocardial infarction and temporary electrical cardiac pacing

INTRODUCTIONnElevated glucose levels on admission in many emergency conditions, including acute myocardial infarction (AMI), have been identified as a predictor of hospital mortality.nnnOBJECTIVEnSince there are no data in the literature related to stress hyperglycaemia (SH) in patients with both AIM and temporary electrical cardiac pacing, we aimed to investigate the influence of stress hyperglycaemia on the prognosis of patients with AMI and temporary electrical cardiac pacing.nnnMETHODSnThe prospective study included 79 patients with diagnosed AMI with ST-segment elevation (STEMI), admitted to the Coronary Care Unit of the Clinic for Cardiovascular Diseases, Clinical Centre Nis, from 2004 to 2007, who were indicated for temporary electrical cardiac pacing. The blood was sampled on admission for lab analysis, glucose levels were determined (as well as markers of myocardial necrosis troponin I, CK-MB). Echocardiographic study was performed and ejection fraction was evaluated by using area length method.nnnRESULTSnThe ROC analysis indicated that the best glycaemic level on admission, which could be used as a predictor of mortality, was 10.00 mmol/l, and the area under the curve was 0.82. In the group without SH, hospital mortality was 3-fold lower 11/48 (22.91%) compared to the group with SH 19/31 (61.29%), p < 0.0001. Patients with SH were more likely to have higher troponin levels, Killip >1, lower ejection fraction and heart rate, as well as systolic blood pressure.nnnCONCLUSIONnThe best cut-off value for SH in patients with AMI (STEMI) and temporary electrical cardiac pacing is 10 mmol/l (determined by ROC curve) and may be used in risk stratification; patients with glucose levels <10 mmol/l on admission are at 3-fold lower risk compared to those with glucose levels >10 mml/l. Our results suggest that SH is a more reliable marker of poor outcome in AMI patients with temporary pace maker, without previously diagnosed DM.

Anxiety and Depressiveness in Students With Childhood War-Related Experiences

The aim of this study was to determine differences in intensity of anxiety and depressiveness, as well as the frequency of the clinically relevant form of these emotions, in students exposed to warfare during childhood. The study included 324 students from Serbia and Kosovo, 18–25 years of age. At the time of the clashes (in 1999), their ages ranged from 6 to 13 years. We used a general questionnaire, the Beck Depression Inventory I (BDI-I), and the Beck Anxiety Inventory (BAI). Approximately two thirds of the examinees had clinically significant anxiety, while one third had clinically significant depressiveness. Females had a higher intensity of anxiety (16.22 vs. 11.6; p < .001) and depressiveness (9.57 vs. 7.05; p = .004) than males. Examinees who reported war-related experiences (WREs) from two or three types of events had more intense anxiety (p = .013) and depressiveness (p = .013) than a group with one or no WREs. There was an association between WREs during childhood and anxiety as well as depression in adolescence that was more prominent in females.

Anxiety, Depression and Childhood War Trauma

Introduction Previous research has confirmed that various types oftrauma, related to both wartime and peacetime, can negatively affectpsychological development and promote the occurrence of mental disorders inyouth and adults. Results of previous studies in the field of post-conflictmental health suggest that certain psychological consequences can persist foryears after traumatic events. Objectives For this reason we have decided to investigate thepresence of anxiety and depression in young people who were exposed towar-related trauma during childhood. Special emphasis is given to clinicallysignificant forms of these emotions. Aims The aim of the study was todetermine the differences in intensity and frequency of clinically relevantanxiety and depression in students exposed to warfare during childhood. Methods The study comprised 324students from Serbia and Kosovo, aged 18-25, exposed to war-related events(WREs) during childhood. We used the Generalquestionnaire, the Beck Depression Inventory I (BDI-I), and the BeckAnxiety Inventory (BAI). Results Approximately 2/3 of all of the examinees had clinicallysignificant anxiety, while 1/3 had clinically significant depression. Thefemales had higher intensity of anxiety (16.22 vs. 11.6; p Conclusions There is an association between WREs duringchildhood and anxiety as well as depression in adolescence, more prominent infemales.

An epidemiological study on herbal product self-medication practice among psychotic outpatients from Serbia: A cross-sectional study

Utilization of herbal products (HPs) is a common practice in the traditional medicine of people from southeastern Serbia. In this study, we focused on the usage of HPs as a self-medication practice among patients diagnosed with a mental illness, by aiming to ascertain the usage prevalence, the identity of the main plant taxa utilized, their formulations and target symptoms. This was accomplished through a cross-sectional study of psychiatric outpatients, conducted in the Clinic for Mental Health Protection in Niš, and which included a questionnaire on HP utilization and a non-structured psychiatric interview. Typically, single, middle-aged males, with a secondary education degree, utilized Matricaria chamomilla and/or Melissa officinalis in a form of an infusion (tea) for relieving anxiety and psychotic symptoms. In some cases, adverse effects were noted when HPs were used in combination with prescribed psychotropic medications. Our and previous results urge a thorough evaluation of possible benefits and/or harmful interactions of HP with standard medication in the treatment of psychiatric patients.

Neurobiology of Psychotherpeutic Relationship-New Perspectives

SUMMARY Since the time of Freud’s “Project for psychology as natural science” in 1895, at the dawn of psychoanalysis as the theory and therapy, psychoanalysis and psychotherapy in general have been attempting to establish and develop their biological roots. Numerous external and internal limitations and resistances have been limiting and opposing this process for almost a century. The last two decades brought a significant change in this view, especially following the development of contemporary neuroimaging techniques with their dynamic and functional features and growing interest for mental processes on behalf of neuroscience. The aim of this paper was to review scientific articles on recent advances in the field of neurobiology of psychotherapy, especially neurobiological underpinnings of psychotherapeutic relationship, and point to the new perspectives this knowledge brings. Recent advances in neurobiology and psychotherapy research open the way for the integration of psychotherapy and neurobiology. With this regard, science could contribute to closing the mind-brain gap which has been artificially dividing a human being for centuries. An integrated field enables new scientific perspective for both disciplines with multilayered understanding of mind-brain functioning. Sažetak Još od vremena Frojdovog „Projekta za psihologiju kao prirodnu nauku“ iz 1895. godine, u začetku psihoanalize kao teorije i terapije, psihoanaliza i psihoterapija uopšte, nastojale su da uspostave i razviju svoje naučne korene. Brojna spoljašnja i unutrašnja ograničenja i otpori suprotstavljali su se ovom procesu gotovo čitav jedan vek. Poslednje dve decenije donele su značajnu promenu, posebno zahvaljujući razvoju savremenih tehnika neuroimidžinga sa dinamičkim i funkcionalnim svojstvima na jednoj i rastućem interesovanju neuronauka za mentalne procese na drugoj strani. Cilj našeg rada bio je da prikažemo pregled naučnih članaka koji se bave novim dostignućima u oblasti neurobiologije psihoterapije, posebno neurobiološke osnove psihoterapijskog odnosa i da ukažemo na nove perspektive koje ovo znanje može da donese. Nedavna dostignuća neurobiologije otvaraju put za integraciju psihoterapije i neurobiologije. U tom smislu, nauka može doprineti zatvaranju jaza duša-mozak, koji je veštački delio predstave o ljudskom biću i njegovom funkcionisanju skoro čitav vek. Integrativno polje omogućava novu naučnu perspektivu za obe discipline, sa slojevitim razumevanjem funkcionisanja jedinstva duša-mozak.

P-408 - Anxiety and chest pain

Introduction Chest pain is characteristic symptom associated with serious heart condition. Almost 10% of all cardiographs is negative and do not confirm ischemic heart disease. Except the other organic causes, the atypical pain is often associated with somatization and psychiatry disorders. Objectives The objectives of our study were to explore difference in pain characteristic between coronary patients and those without diagnose of coronary disease and presence of psychiatric syndromes. Method We have compared 30 out patients with angina pectoris (C group) to 30 patients with atypical chest pain (A group) and normal results of cardiac examination. The other medical pain causes were also excluded. Applied instruments were: Visual Analog Pain Scale, Questionnaire for affective and sensorial characteristic, M.I.N.I.,for psychiatric diagnose SCL-90-R, for psychological dimensions, Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) for anxiety and depression level. Results Atypical chest pain was mild, les intensity than ischemic pain, accompanied with panic affect and sharp sensitive features. There were no difference in other pain characteristics: localization, propagation, duration, between groups. Panic and somatoform disorders were present at A group (23%:0%, pxa0 Conclusion There is slight difference in chest pain expression between coronary and noncoronary patients, presence of associated panic and somatization disorder and elevated somatization and anxiety level, indicates possible psychogenesis.

P01-388 - Risk health behavior and psychological reactions after cardiac event

Introduction Risk health behavior can influence coronary syndromes outcome, especially associated with undesirable psychological reactions. Anxiety and depressive syndromes could be associated with higher frequency of smoking, alcohol consumption and lack of physical activity. Objectives Assesment of differences in psychological and behavior parameters between acute coronary and healthy controls and influence on 6 months re- hospitalization rate. Method Comparation between K groupxa0=xa033 of first myocardial infarction patients and E groupxa0=xa030 healthy persons at baseline and after 6 months. Instruments applied: Semistructured psychiatric interview, M.I.N.I., Beck Anxiety Inventory (BAI) for anxiety level, Beck Depression Inventory (BDI) for depression level, KON-6 sigma Aggression Scale and Holms-Rahe (H-R) Stress Life Events Scale and Questioner for risk health behavior. Parameters differences were assessed by t-test chi square test, for p Results Anxiety-depressive and Anxiety syndromes were present at 23% of K group and 10% of E group. Anxiety level of K group was higher than E: (BAIxa0=xa08,15xa0±xa04,37:4,83xa0±xa02,60; txa0=xa0−3,62), for pxa0 Conclusion Anxiety and depression levels are mild in K group. Risk health behavior has been present at bouth groups but alcohol consumption and family disposition are important for re-hospitalization