Hair for a long-term biological indicator tissue for assessing the strontium nutritional status of men and women.

Strontium (Sr) is a trace element that closely resembles calcium metabolism. At the present time there is no available long-term biological indicator tissue for assessing the human Sr nutritional status. Here we have presented a novel concept on how to assess the Sr nutritional status by studying the frequency distribution properties of hair Sr (SrH) concentration. In this prospective, observational, cross-sectional, and exploratory epidemiological study, we analyzed SrH in 311 apparently healthy adult Croatians (123 men, 188 women). Hair strontium was analyzed by the ICP-MS. The natural frequency distribution of SrH followed the Power law, so that the data were analyzed by fitting the logistic bioassay sigmoid curve (ogive) of median derivatives. Women tend to accumulate three and a half time more SrH than men (median men 867ngg-1 vs. median women 3120ngg-1). The normal (adequate) linear physiological response range of the sigmoid curve was 351-3489ngg-1 for men and 846-8457ngg-1 for women. Values below that linear range are considered to indicate deficient Sr nutritional status, whereas values above that linear range indicate excessive strontium exposure. Hair, as a long-term, and whole blood as a short-term biological indicator tissues were not commensurable entities. Similarly, SrH accumulation was not age dependent in either men or women. Hair strontium is a reliable long-term biological indicator tissue for assessing the strontium nutritional status.

High hair selenium mother to fetus transfer after the Brazil nuts consumption.

Lactating mother and her two month old healthy daughter (APGAR 10) gave their scalp hair for a multielement profile analysis; 25 elements were analyzed with the ICP MS. Mother's hair was divided into 5cm long segment proximal to the scull (Young), and the distal segment further up to the hair tip (Old). One centimeter of hair records one month of the metabolic activity of the bioelements in the body. Mother's Young hair and daughters hair have 2.70 and 9.74µgg(-1)Se, a distinctly higher Se concentrations than the Old hair of 0.87µgg(-1). The adequate hair Se concentrations in Croatia women population vary from 0.08 to 0.63µgg(-1); values below or above that range indicate deficiency or excess, respectively. Dietary recall revealed that during the last trimester of pregnancy and over a period of a week, the mother has consumed 135g of Brazil nuts (Bertholletia excelsa) (BN); BN is an exceptionally rich Se dietary source. The amount of Se in BN varies and one week consumption of 135g of BN may result in Se daily intake of 367 to 492µgg(-1)day(-1) over a period of seven consecutive days, and what is about or exceeds the Upper Limit of daily selenium intake of 400µg(-1)g(-1). The excessively high infant hair Se mirrored a natural high mother to fetus transplacental transfer of bio elements in the last trimester of pregnancy. The potential toxicological risks of such a high Se transfer remains to be elucidated.

Results of the clinical examination of an ointment with marigold (Calendula officinalis) extract in the treatment of venous leg ulcers.

The aim of this study was to determine the therapeutic efficacy of marigold (Calendula officinalis) extract on the epithelialization of lower leg venous ulcers. The experiment was carried out in 34 patients with venous leg ulcers. The patients were divided into two groups. In the first (experimental) group, patients were treated with an ointment containing marigold extract, which was prepared in an apparatus devised by Soxleth and was incorporated into a neutral base. Twenty-one patients with 33 venous ulcers were treated. Therapy was applied twice a day for 3 weeks. The second group was a control group that consisted of 13 patients with 22 venous ulcers. In the control group, saline solution dressings were applied to ulcers for 3 weeks. In the experimental group the total surface of all the ulcers at the beginning of the therapy was 67,544 mm2. After the third week the total surface of all the ulcers was 39,373 mm2 (a decrease of 41.71%). In seven patients, complete epithelialization was achieved. In the control group the total surface of all the ulcers at the beginning of the therapy was 69,722 mm2. After the third week the total surface of all the ulcers was 58,743 mm2 (a decrease of 14.52%). In four patients, complete epithelialization was achieved. There was a statistically significant acceleration of wound healing in the experimental group (p < 0.05). The results obtained are preliminary, but they suggest the positive effects of the ointment with marigold extract on venous ulcer epithelialization.

Results from a Phase II Study to Assess the Clinical and Immunological Activity of AFFITOPE® AD02 in Patients with Early Alzheimer's Disease.

OBJECTIVES: The primary objective of this clinical trial was to assess the clinical activity of various doses and formulations of AFFITOPE® AD02 following its repeated s.c. administration to patients with early Alzheimer´s disease (AD), based on the evaluation of cognitive and functional domains. DESIGN: It was designed as a randomized, placebo-controlled, parallel group, double blind, multicenter phase II trial with 10 regular outpatient visits and 6 telephone interviews. SETTING: The trial was performed at 32 sites in six countries. PARTICIPANTS: A total of 332 patients were enrolled and 265 patients completed the trial in 3 treatment groups with AD02 and 2 control groups with aluminum oxihydroxide, here named IMM-AD04. Patients were randomly assigned to 5 groups: two doses of IMM-AD04, 25µg AD02 (in two different formulations) and 75µg AD02. INTERVENTION: At months 0, 1, 2, 3, 9 and 15, each patient received a single s.c. injection of the corresponding preparations of AFFITOPE® AD02 or the control, IMM-AD04. MEASUREMENTS: Co-primary efficacy outcomes included a measure of cognition (adapted AD Assessment Scale cognitive [aADAS cog]), and a measure of function (adapted AD Cooperative Trial Activities of Daily Living [aADCS-ADL]). A primary composite score was the sum of these two scores. RESULTS: Treatments were generally well tolerated and adverse events (AEs) were seen at similar rates across all treatment groups, with the exception that more injection site reactions were seen in the groups with a higher level of adjuvant. None of the AD02 groups showed a benefit over the IMM-AD04 controls for primary or exploratory efficacy outcomes. The control groups differed on aADCS-ADL and therefore couldn't be pooled (p=0.039). Unexpectedly, the 2mg IMM-AD04 showed statistically significant effects over the other groups on several clinical outcomes including: aADAS-cog, aADL, Composite, ADAS-cog, CDR-sb, and QOL-AD Caregiver as well as two biomarker outcomes: right and total hippocampal volume (all p<0.05). 48% of patients in the IMM-AD04 2mg group had no decline in the composite outcome over 18 months compared to 17%-31% in the other groups, which is consistent with historical placebo groups. CONCLUSION: No significant treatment effects were seen for the investigational compound AD02. However, the IMM-AD04 2mg group showed statistically significant effects over all other groups on several clinical outcomes as well as a slowing of decline on right hippocampal volume. The data support further development of IMM-AD04 as a disease modifying agent in line with EMA/FDA definitions.

Posttraumatic stress disorder and platelet serotonin measures.

The role of serotonin (5HT) in the pathophysiology of posttraumatic stress disorder (PTSD) has been suggested by the overlap in clinical symptoms between PTSD and psychiatric conditions in which a serotonin dysfunction is implicated, as well as by the therapeutic efficiency of 5HT-related drugs (antidepressants, selective serotonin reuptake inhibitors and monoamine oxidase inhibitors) in alleviating symptoms in PTSD. In the present study, the blood platelet, which has been proposed as a peripheral model for the central serotonergic neurons, has been used to search for alterations in 5HT mechanisms in PTSD. Platelet serotonin level and kinetics of serotonin transporter and monoamine oxidase (MAO-B) were assessed in 63 combat-related PTSD patients and 43 sex and age-matched control subjects. A significant reduction in maximal velocity of platelet MAO-B (approx. 30%), with no changes in the enzyme affinity was observed in our patient sample. Conversely, no alterations in kinetic parameters (V(max), K(m)) of platelet serotonin transporter, as well as in platelet 5HT level, were found in the PTSD group.

[Disability and arthrotic changes in the lower extremity]. / Invalidnost i artrotske promjene donjih ekstremiteta.

From a sample of occupationally disabled persons who had retired because of a disease of the locomotive system 48 men and 22 women with pronounced arthrotic changes in lower extremities were selected for the study. A comparative group, which was matched to the experimental one by age (53.8 +/- 4.2 years) and sex, consisted of occupationally disabled persons who had rheumatic complaints, but no arthrotic changes in the lower extremities. All the subjects in the study were given a questionnaire to answer and underwent a clinical examination and an X-ray of the locomotive system. Marked symptoms of arthrosis were manifest in those aged 46 +/- 6 years. Besides occupation (coxarthrosis and gonarthrosis occurred more frequently among unskilled (54.2%) and skilled (25%) workers) a major risk factor were injuries (37.1% as against 5.7% in the comparative group). At clinical examination men complained much more often of spontaneous pain in the hip joints (60% as against 22.3% in women), whereas women more often complained of painful movements (63.6% as against 45.8% in men). The objective symptoms of gonarthrosis, crepitations and restricted movements in the first place, were present in men and women alike. The relative body mass (RBM), expressed as percentage of decline from ideal was, particularly among women, a significant risk factor for the occurrence and development of coxarthrosis and gonarthrosis. As much as 50% of the women with arthrosis had RBM higher than 140%, and another 40% had RBM between 120 and 140%. In the comparative group the respective percentage was 27.3% (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

[Diagnostic and therapeutic guidelines (algorithms) in the treatment of schizophrenia. Recommendations of the Croatian Society for Clinical Psychiatry of the Croatian Medical Association]. / Dijagnosticke i terapijske smjernice (algoritam) za lijecenje shizofrenije. Preporuke Hrvatskog drustva za klinicku psihijatriju. Hrvatskoga lijecnickog zbora.

This paper presents guidelines for the diagnosis and treatment of schizophrenia. Diagnostic guidelines are based on ICD-10 criteria for diagnosis of schizophrenia. Treatment guidelines represent a synthesis of some recently published international algorithms and our own experiences. The guidelines were presented at the seminar organized by the Croatian Association for Clinical Psychiatry and represent professional recommendations of the Association for Diagnostics and Treatment of Schizophrenia. The treatment guidelines include psychopharmacological recommendations for the selection and dosage of antipsychostics, guidelines for psychosocial interventions and psychotherapy. The treatment of the first episode, exarcerbation, relapse of illness, as well as maintenance therapy, treatment resistance and side effects are included.

Rating scales and computed tomography in multi-infarct dementia.

Forty patients who fulfilled the DSM-III-R criteria for multi-infarct dementia and had a score of 7 points or more on Hachinski ischemia score (HIS) were analyzed with the purpose to correlate the rating scales and CT scans. Among the examined patients there were 32 women with the average age of 68.5 +/- 9.8 years and 8 men with the average age of 68.8 +/- 10.4 years. No significant difference between sex in relation to Folstein Mini-mental state examination (MMSE), Gottfries-Brane-Steen scale (GBS) and Sandoz clinical assessment-geriatric scale (SCAG) was found. There is no correlation of GBS and SCAG on MMSE. With regression analysis a good correlation was found between GBS and SCAG, and we suggest that in such studies only one of these two scales is sufficient. CT abnormalities were found in about 77% of examined patients without difference according to sex. But, GBS score demonstrated greater disability among MID patients with abnormal CT scans than in MID patients with normal CT scans. In medical history of male MID patients completed stroke was significantly more common than among women, while the female MID patients had in their history significantly more frequent transient ischemic attack (TIA). This finding should be checked in a greater patient population. It is stressed that in everyday clinical practice it is necessary to use the diagnosis of multi-infarct dementia, e.g. to differentiate cerebral diseases according to etiology and pathogenesis.

RETRACTED: A novel concept to derive iodine status of human populations from frequency distribution properties of a hair iodine concentration.

This article has been retracted: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been retracted at the request of the Editor-in-Chief. The article is a duplicate of a paper that has already been published in JOM, volume 28 (2013), 175­185, https://bib.irb.hr/datoteka/684767.Iodine_Orthomolecular_Momcilovic.pdf. One of the conditions of submission of a paper for publication is that authors declare explicitly that the paper has not been previously published and is not under consideration for publication elsewhere. As such this article represents a misuse of the scientific publishing system. The scientific community takes a very strong view on this matter and apologies are offered to readers of the journal that this was not detected during the submission process.

Catatonic schizophrenia in Croatia.

A representative sample of schizophrenic subjects was collected for epidemiological and clinical follow-up in 1972 from the pool of 8069 patients registered in the Croatian Psychotics Case Register (CPCR). This sample comprised 402 patients (207 males and 195 females), who were followed up until 1990/91. The diagnosis of schizophrenia, catatonic type according to ICD-8 (V/295.2), was made in 59 cases (14.7%; 28 males, 31 females) at least once in the course of the follow-up. This study presents data concerning the diagnostic instability of the catatonic subtype during the long-term follow-up. As subtype diagnoses were frequently changed over the course of illness, at the end of the follow-up, the diagnosis of catatonic schizophrenia was only confirmed in 11 (18.6%) cases. Positive family history of psychosis was found in 44.1% of catatonic patients, a percent significantly greater than the corresponding figure for all non-catatonic schizophrenic subtypes combined (20.1%). This study provides preliminary evidence that the catatonic subtype of schizophrenia is a separate diagnostic entity with a high familial loading.

Psychotic symptoms and comorbid psychiatric disorders in Croatian combat-related posttraumatic stress disorder patients.

AIM: To investigate the prevalence rate of post-traumatic stress disorder (PTSD) comorbid psychiatric disorders and to explore psychotic symptoms in patients with combat-related current PTSD. METHOD: The sample included Croatian war veterans (N=41) who were hospitalized at the University Department of Psychiatry of the Vrapèe Psychiatric Hospital during the 1995-1996 period and fulfilled the DSM-IV criteria for the current and chronic PTSD. The Schedule for Affective Disorder and Schizophrenia (SADS-L) was applied for the assessment of current and lifetime psychiatric disorders. Only three subjects had a prewar Axis I psychiatric disorder. One third of the patients met the criteria for personality disorder. RESULTS: After severe combat trauma, the majority of PTSD patients (33/41) had at least one comorbid psychiatric diagnosis on Axis I. In those with personality disorders the most frequent was alcohol dependence, whereas in those without personality disorders it was major depressive disorder. Psychotic symptoms occurred in 8 out of 41 PTSD patients. None of them had a primary psychotic disorder or a personality disorder. In all the patients, psychotic symptoms were different from flashbacks. They were symbolically related to the trauma and resistant to antipsychotic treatment. Psychotic symptoms were associated with depression in 5 out of 8 patients with psychotic symptoms. CONCLUSION: Severe and prolonged combat trauma may be followed by the co-occurrence of PTSD and psychotic symptoms, forming the atypical clinical picture of PTSD.

Catatonic schizophrenia has a shorter pre-hospitalisation interval than other types of schizophrenia.

The time elapsed between the first onset of symptoms and the onset of first hospitalisation was analysed in 355 participants diagnosed with paranoid, simple, hebephrenic and catatonic schizophrenia and shizoaffective disorder. The real onset of the disease was assessed from interviews with reliable relatives and by reviewing medical records in general practices and out-patient psychiatric services. In 184 patients a family history of schizophrenia was identified. A positive family history was found to significantly increase the interval preceding first hospitalisation in all analysed types, except in catatonic schizophrenia. Possible reasons causing this prolongation are discussed, as well as repercussions of the results to studies using age of first hospitalisation as the leading indicator.