Trace elements concentrations association with schizophrenia symptoms; A cross-sectional study in Croatia.

BACKGROUND: Significant inconsistencies exist in findings on association of bio-elements (BE) concentrations and schizophrenia. Hypothesis of this research was that different concentrations of BE are associated with different psychopathological schizophrenia symptoms. SUBJECTS AND METHODS: This cross-sectional study was performed from 2014 to 2016 at Psychiatric Hospital "Sveti Ivan" and University Psychiatric Hospital "Vrapce", Zagreb, Croatia, on the consecutive sample of 67 patients diagnosed with schizophrenia. BE concentrations were measured by Inductively Coupled Plasma Mass Spectrometry (ICP-MS) at the Institute for Medical Research and Occupational Health in Zagreb. Severity of schizophrenia symptoms was assessed on Brief Psychiatric Rating Scale (BPRS). RESULTS: After adjustment for all preplanned possible confounding variables, the first canonical correlation between BE and BPRS dimensions variates were statistically significant (Rc2=0.73; P=0.006). The first pair of canonical variates is defined by BPRS negative dimension (and marginally by positive symptoms and lack of resistance), and copper (Cu), lead (Pb), lithium (Li) and cobalt (Co) (marginally by cadmium (Cd) and nickel (Ni)). CONCLUSIONS: Concentrations of different BE are associated with different schizophrenia symptoms. Maximal correlation between BPRS and BE may be achieved with the weighted linear composite of negative schizophrenia symptoms and copper (Cu), lead (Pb), lithium (Li) and cobalt (Co).

Hair iodine for human iodine status assessment.

BACKGROUND: Today, human iodine deficiency is, after iron, the most common nutritional deficiency in developed European and underdeveloped third world countries. A current biological indicator of iodine status is urinary iodine, which reflects very recent iodine exposure; a long-term indicator of iodine status remains to be identified. METHODS: We analyzed hair iodine in a prospective, observational, cross-sectional, and exploratory study involving 870 apparently healthy Croatians (270 men and 600 women). Hair iodine was analyzed with inductively coupled plasma mass spectrometry. RESULTS: The hair iodine median was 0.499 µg/g, and was 0.482 and 0.508 µg/g for men and women respectively, suggesting no sex-related difference. We studied hair iodine uptake by analyzing the logistic sigmoid saturation curve of the median derivatives to assess iodine deficiency, adequacy, and excess. We estimated overt iodine deficiency to occur when hair iodine concentration was below 0.1-0.15 µg/g. Then there was a saturation range interval of about 0.1-2.0 µg/g where the deposition of iodine in the hair was linearly increasing (R(2)=0.994). Eventually, the sigmoid curve became saturated at about 2.0 µg/g and upward, suggesting excessive iodine exposure. CONCLUSION: Hair appears to be a valuable and robust biological indicator tissue for assessing long-term iodine status. We propose that an adequate iodine status corresponds with hair iodine uptake saturation of 0.565-0.739 µg/g (55-65%).

Ejaculatory dysfunction in patient with schizophrenia on sertindole.

The antipsychotic drugs can be of great benefit for the wide range of psychotic disorders, but all are associated with various adverse effects. Patients with psychotic disorder consider the sexual dysfunction to be among the most important side effects. Although, it is not uncommon for the patients with schizophrenia to report the sexual dysfunction, patients with untreated schizophrenia have fewer dysfunctions compared to those on antipsychotic medication. The decision whether the current treatment with a prolactin-increasing antipsychotic or sexual dysfunction inducing drug should be continued or switched to another antipsychotic drug, has to be made on the basis of the patient's risk-benefit estimation. It has to be kept on mind that adverse effects are usually dose dependent. In this case report, sertindole treated patient with chronic schizophrenia developed sexual side effect manifested as ejaculatory dysfunction that was significantly ameliorated by drug-dose reduction.

Involuntary emotional expression disorder in Alzheimer's disease - psychopharmacotherapy aspects.

Involuntary emotional expression disorder (IEED) is syndrome characterized with relatively stereotypical episodes of uncontrollable crying and/or laughing. Additionally, this syndrome can include irritability, anger and frustration. This syndrome is common among a number of neurologic diseases like patients with a stroke or traumatic brain injury (TBI), patients with amyotrophic lateral sclerosis (ALS), multiple sclerosis (MS), as well as dementias such as Alzheimer's disease (AD), and motor disorders such as Parkinson's disease (PD). IEED is very common but misdiagnosed and consequently undertreated. Prevalence of IEED in AD is between 15-39%. Recent controlled clinical studies suggest that dextromethorphan (DM) and quinidine (Q) is an effective treatment for IEED. United States Food and Drug Administration (FDA) has accepted for filing and review its New Drug Application (NDA) for Zenvia (dextromethorphan hydrobromide and quinidine sulfate capsules) for the treatment of IEED. In Republic of Croatia current treatment involves antidepressants (tricyclic and selective serotonin reuptake inhibitors), antipsychotic agents, anxiolytics, antidementives and mood stabilizers. New promising treatment can reduce the frequency of episodes and improve the quality of life of patients and their families and caregivers.

Effect of olanzapine on disruptive behavior in institutionalized patients with severe intellectual disability--a case series.

Considerable number of intellectual disabled people experience some form of disruptive behavior. Antipsychotics are the most common treatment for these behaviors. Numerous patients were efficiently treated with thioridazine, recently withdrawn. The authors describe a case series of "thioridazine responders" treated with olanzapine. Thirty three patients with severe intellectual disability were recruited. All patients were assessed for seven types of disruptive behavior on five point scale. Patients with severe behavior disturbances were included in treatment. The time points of assessment were at day 0, 30, 60 and 180. Twenty one patient accomplished inclusion criteria. A significant decrease occurred at day 30 for all types of behavior. Total score, self injurious behavior, compulsive and destructive behavior showed further decrease at day 60 and became stable until the end of study. Olanzapine appears to be efficacious in the treatment of disruptive behavior in the intellectually disabled and could be substitute for thioridazine treatment.

Trapped between tradition and transition--anthropological and epidemiological cross-sectional study of Bayash Roma in Croatia.

AIM: To assess the key characteristics related to living conditions and health in the Bayash Roma population in Baranja and Medimurje regions of Croatia and identify possible demographic and socio-economic sources of variance in self-reported health and reproductive profile. METHODS: The study comprised a total of 266 adult Bayash individuals from Baranja and 164 from Medimurje (aged 41.3+/-15.1 years). Data on ethno-historical and demographic background, self-identity, life and hygiene conditions, education, employment, health insurance, and health (dietary and smoking habits, reproductive characteristics, diagnosed and undiagnosed health problems, use of medications). were obtained through interviews. Bivariate and multivariate methods were used in statistical analyses. RESULTS: The reported migratory pattern demonstrated that 88.8% of the examinees were born in the region of residence, which showed that the Bayash population was autochthonous and sedentary one. Financially, the Bayash primarily relayed on social welfare support allowance (84%) and child allowance (47%), while merely 2% were permanently and 23% occasionally employed. The proportion of the Bayash who had never attended school amounted to 33.3% (19.3% men and 40.6% women). The access to public water supply system was available to 52.5% of examinees, whereas only 1.7% had public sewage system, and 23.4% had private septic tanks. The most commonly reported health burden were frequent headaches (20.3%), stomach pain (16.3%), anxiety or insomnia (13.1%), hypertension (9.3%), and chronic obstructive pulmonary disease (COPD) (8.6%). The logistic regression identified level of education (odds ratio [OR], 0.77; 95% confidence interval [CI], 0.63-0.94) and access to health insurance (OR, 4.32; 95% CI, 1.46-12.77) as socio-economic/life-style factors playing a significant role in the occurrence of COPD. CONCLUSION: Our results indicate poor inclusion of the Bayash in the essential social service sectors such as health care, education, and employment, as well as substandard living conditions and unfavorable health-related behavior. Since education and health insurance were found to have significant effects on the observed reproductive status and self-reported health, they should be targeted in planning public health actions for socially marginalized and economically deprived groups.