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Biomedical subjects

M Jakovljević

Publications and source records attributed to M Jakovljević.

At least 19 recordsLinked to original sources
PubMed2003

Olanzapine in the treatment-resistant, combat-related PTSD--a series of case reports.

OBJECTIVE: Nightmares and insomnia in combat-related post-traumatic stress disorder (PTSD) might be resistant to treatment with selective serotonin reuptake inhibitors (SSRIs) and benzodiazepines. METHOD: We describe five case reports of patients suffering from long-lasting and intractable nightmares and insomnia. They were given different psychotropic agents in past few years, with no improvement in their sleep disturbance. Olanzapine was added to the current treatment regimen. RESULTS: Both nightmares and insomnia improved rapidly after olanzapine institution in all of five patients. No adverse events of olanzapine were reported. CONCLUSION: Olanzapine augmentation might be useful in alleviating treatment-resistant nightmares and insomnia in patients with combat-related PTSD.

Adult↗
PubMed2003

Postcardiotomy assisted circulation with roller pump--early and late results.

The incidence of postcardiotomy myocardial failure (PMF) requiring mechanical circulatory support beyond IABP is reported to be 0.2% to 1.2%. From Dec. 1989 through Dec. 1995, 18 patients (0.3% of the total pump cases) were supported with roller pump type of LVAD. Assisted flow ranged from 3.5 up to 5 L/min with average support time of 35.5 hours. Six (33.3%) patients died while on LVAD. The causes of additional seven deaths (pts weaned of LVAD) were: myocardial failure (4), stroke (2) and intractable bleeding during removal of the LVAD (1). Overall, five patients (27.8%) were successfully discharged from the hospital. Two out of five long-term survivors died later, 6 months and 4 years postoperatively, both of cardiac causes. The actuarial survival rate of long-term survivors was 60% at 7 years, all of them being in NYHA functional class II. These results have proved efficiency of roller pump driven LVAD for short-term circulatory support in pts with PMF. Results are comparable to so far published data on postcardiotomy support with the same, as well as other types of more versatile and costly devices.

Aged↗
PubMed2002

[Combined use of internal mammary and right gastroepiploic arteries in myocardial revascularization with and without extracorporeal circulation].

Use of arterial grafts represent the new approach in coronary artery bypass grafting (CABG) surgery these days. This article represents our experience in use of two or more arterial grafts in combination (internal mammary artery--IMA and right gastroepiploic artery--RGEA). Between March 2000 February 2002, 10 patients underwent CABG with exclusive use of left or both IMAs and RGEA, with or without extracorporal circulation (ECC). In the group without ECC fast truck anesthesia was used. Post CABG catheterization was performed in three patients. There were no 30 day mortality or morbidity. Post CABG catheterization in two patients showed excellent graft patency. One patient continued to have chest pain and after the catheterization we found ostial narrowing of the celiac trunck which was successfully dilated. One of participants had abdominal hernia repair. Our opinion is that use of arterial grafts in CABG surgery has much lower risk, excellent patency and good long term prognosis.

Aged↗
PubMed2002

Gender differences in depression.

Depression is twice as common in women as in men, although some concern has been raised in terms of misdiagnosing depression in men. The incidence of depression in women varies during the life span. The peak incidence during childbearing years appears to be associated with cyclic hormonal changes. Women also present with reproductive -specific mood disorders: pre-menstrual dysphoric disorder (PMDD), depression in pregnancy, postpartal mood disorder (PDD) and perimenopausal depressive disorder. Gender differences were repeatedly observed in response to antidepressant medication. Premenopausal women appear to respond poorly and to show low tolerability to TCAs, but they tend to show greater responsiveness to the SSRIs. In contrast, men and postmenopausal women can respond equally to the TCAs and SSRIs. These differences are contributed to gender differences in pharmacokinetics of antidepressants and to the influence of menstrual cycle. These findings suggest the need for a gender-specific approach to the evaluation and management of depression.

Antidepressive Agents↗
PubMed2001

Platelet serotonin concentration in dialysis patients with somatic symptoms of depression.

Platelet serotonin (5-HT) concentration was measured in 65 male and 45 female chronic renal patients on hemodialysis (HD) with different somatic symptoms of depression (crying spells, irritability, sleep disturbance, fatigability, loss of appetite, weight loss, somatic preoccupation and loss of libido), to find out the relationship between the severity of symptoms and platelet 5-HT concentration. Male and female patients had significantly lower platelet 5-HT concentration than 62 male and 38 female healthy subjects. Gender-differences in platelet 5-HT values observed in healthy subjects were not found in patients. Platelet 5-HT concentration differed in the groups of patients with the different scores of particular somatic symptoms (loss of appetite and loss of libido), but was similar in patients with other somatic symptoms. There was no relationship between platelet 5-HT concentration and the severity of somatic symptoms, or between platelet 5-HT concentration and age of the patients. Gender-related differences in the occurrence of somatic symptoms were detected in patients with the different degrees of weight loss, somatic preoccupation and loss of libido. Our results suggest that platelet 5-HT concentration could not be used as a biological marker for the severity of somatic symptoms in chronic renal patients on HD.

Adolescent↗
PubMed2001

[Use of the internal thoracic artery in repeat myocardial revascularization surgery].

The incidence of redo myocardial revascularization is increasing lately. These procedures are accompanied by the higher operative risk, and the use of internal thoracic artery graft may have additional negative impact on early-rization. Mortality and morbidity in this group did not differ significantly compared to a group where only venous grafts were used. Independent predictors of the unfavorable outcome (for both groups) were the presence of the chronic pulmonary disease, age over 65 and NYHA functional class IV. In the group with internal thoracic graft it was the age over 65, while in the group with only vein grafts it was chronic pulmonary disease. We have discussed potential problems during the redo procedure in patients in whom internal thoracic graft was used during the first procedure.

Aged↗
PubMed1999

Platelet serotonin, plasma cortisol, and dexamethasone suppression test in schizophrenic patients.

BACKGROUND: Serotonin (5-HT) regulates hypothalamic-pituitary-adrenal (HPA) axis activity. Abnormal response to the dexamethasone suppression test (DST) and altered platelet 5-HT concentration have been shown in some schizophrenic patients. METHODS: Platelet 5-HT and plasma cortisol concentrations were determined simultaneously in 86 male schizophrenic patients before and after DST. Basal plasma cortisol and platelet 5-HT levels were also determined in 69 healthy male persons. RESULTS: Schizophrenic patients had higher plasma cortisol and platelet 5-HT concentrations than healthy persons. An abnormal escape from dexamethasone suppression was observed in 50% of patients. In these patients predexamethasone cortisol and platelet 5-HT concentrations were higher than in patients with normal DST. CONCLUSIONS: This study demonstrates that schizophrenic patients have the HPA axis dysregulation that could be connected with a disturbance in the 5-HT system.

Adult↗
PubMed1999

Sex differences, season of birth and platelet 5-HT levels in schizophrenic patients.

Similar occurrence of schizophrenia was observed in men and women independent of their season of birth. Platelet 5-HT concentration was determined in 116 healthy control subjects (61 male and 55 female) and 152 patients with schizophrenia (96 male and 56 female). Platelet 5-HT concentration was significantly higher in male than in female healthy persons and schizophrenic patients. Male and female healthy subjects born in different seasons had similar platelet 5-HT concentrations, whereas schizophrenic patients with different birth-seasons had significantly different platelet 5-HT concentrations. The highest platelet 5-HT levels were observed in both male and female schizophrenic patients born in winter when compared to matched healthy controls. Male schizophrenic patients born in winter had higher platelet 5-HT levels than schizophrenic men born in spring and summer. Female schizophrenic patients born in winter had higher platelet 5-HT than schizophrenic women born in all other seasons. These results indicated sex differences in platelet 5-HT levels in healthy persons and schizophrenic patients. The relationship between season of the birth and platelet 5-HT concentration observed only in schizophrenic patients added further support to the presumption that schizophrenia is connected with a disturbance in the central serotoninergic system.

Adolescent↗
PubMed1998

Platelet 5-HT and plasma cortisol concentrations after dexamethasone suppression test in patients with different time course of schizophrenia.

Platelet 5-HT and plasma cortisol concentrations were determined in 59 schizophrenic patients with different time course of illness before and after dexamethasone suppression test (DST). An abnormal DST (nonsuppression) was observed in 51% of patients. In these patients basal cortisol and platelet 5-HT concentrations were higher than in patients with normal DST. After DST, plasma cortisol levels were higher in nonsuppressors with intermittent and intermittent-chronic time course, whereas platelet 5-HT concentrations were increased in nonsuppressors with intermittent-chronic time course. The results suggest that schizophrenic patients have dysregulated hypothalamic-pituitary-adrenal axis as shown by a high rate of DST nonsuppression, and that nonsuppressors showed hypercortisolemia and hyperserotonemia independent of the time course of schizophrenia. No significant association between DST and time course of the illness was found.

Adult↗
PubMed1998

Influence of long-term fertilization on the selenium content of calcareous chernozem soil.

Available data on the selenium (Se) content in Yugoslavian soils indicate that the element is present in small amounts (< 500 microg/kg in Se-deficient soils). There are no data on the effect of various fertilizers on the Se content in Yugoslavian soils. In our study, we examined the effect of the long-term application of mineral and organic fertilizers (farmyard manure and cornstalks) on the content of Se in calcareous chernozem soil. The experiment of the Maize Research Institute in Belgrade was set up in 1971 and soil samples were examined by chemical analysis after 23 years. The following important conclusions can be drawn based on the analytical data obtained. The total content of Se in the investigated experimental variants in calcareous chernozem soil ranges from 166 to 593 microg/kg. All the variants had a higher content of Se than soil samples taken before the experiment was set up. Comparison with the control (variant without fertilizers) indicated that the Se content increased in the experimental variants where farmyard manure had been applied. This effect was noticed to a depth of 80 cm. Application of farmyard manure should be considered as a means of increasing the levels of Se in Se-deficient soil. Correlation coefficients between total Se content in the soil and some important agrochemical properties of the investigated soils are presented in this paper.

Agriculture↗
PubMed1997

Hypothalamic-pituitary-adrenal axis function and platelet serotonin concentrations in depressed patients.

Plasma cortisol and platelet serotonin (5-hydroxytryptamine, 5-HT) concentrations were determined in 39 male psychotic and 39 male non-psychotic depressed inpatients, and in 69 male healthy control subjects. Psychotic or non-psychotic depressed patients had higher predexamethasone plasma cortisol levels than found in the control group. After the dexamethasone suppression test (DST), psychotic and non-psychotic depressed patients were subdivided into suppressors and non-suppressors. Psychotic and non-psychotic patients had significantly different platelet 5-HT concentrations among themselves and compared with the control group. However, there was no significant correlation between plasma cortisol levels and platelet 5-HT concentrations. Dexamethasone administration did not affect platelet 5-HT concentrations within subtypes of depressed patients. Abnormal cortisol suppression after the DST occurred more frequently in psychotic than in non-psychotic patients. Platelet 5-HT and plasma cortisol concentrations were decreased in patients with pronounced suicidal behaviour. Our results suggest that plasma cortisol and platelet 5-HT concentrations might serve as independent biological markers for different subtypes of depression.

Adult↗
PubMed1997

Association analysis of the 5-HT2C receptor and 5-HT transporter genes in bipolar disorder.

We selected 42 patients with bipolar disorder type I (BPI) and 40 healthy controls for genetic analysis of DNA polymorphisms in the serotonin receptor 2c (5-HTR2c) and serotonin transporter (5-HTT) genes. No significant associations were found in the total patient sample. However, when the individuals were divided according to gender, trends for association with both polymorphisms (P = 0.051 for 5-HTR2c and P = 0.049 for 5-HTT) in female patients were observed. These results suggest that variations in these genes may be responsible for a minor increase in susceptibility for bipolar disorder in women.

Adult↗
PubMed1997

Seasonal influence on platelet 5-HT levels in patients with recurrent major depression and schizophrenia.

The influence of seasons on platelet serotonin (5-HT) concentration was determined in 88 unipolar depressed and 117 schizophrenic male inpatients, and 90 normal male controls. Platelet 5-HT concentrations showed moderate, but insignificant intragroup seasonal variations in healthy controls and in the groups of depressed (psychotic and nonpsychotic) and schizophrenic (positive and negative) patients. In spring, platelet 5-HT concentrations were higher in schizophrenic patients than in normal controls or in depressed patients, while in other seasons platelet 5-HT concentrations were not significantly different between the groups. Higher platelet 5-HT concentrations were detected in psychotic when compared to nonpsychotic depressed patients in summer, fall, and winter. Increased platelet 5-HT concentrations observed in schizophrenic patients with positive symptoms clearly separated these patients from patients with negative schizophrenia, especially in spring, summer, and fall. Our results indicate the necessity to match patients with regard to the season of the sampling, and to divide depressed and schizophrenic patients into subtypes.

Adult↗
PubMed1997

Analysis of the tyrosine hydroxylase and dopamine D4 receptor genes in a Croatian sample of bipolar I and unipolar patients.

We selected 83 patients with bipolar disorder type I or unipolar recurrent major depression and 71 healthy controls for genetic analysis of the tyrosine hydroxylase and the dopamine D4 receptor gene. No significant association was found between bipolar disorder type I and unipolar recurrent major depression and the polymorphisms located near these genes. Therefore, the hypothesis that the tyrosine hydroxylase and the dopamine D4 receptor genes may be involved in the etiology of bipolar disorder and unipolar recurrent major depression is not supported in our study.

Adult↗
PubMed1997

Platelet 5-HT levels and hypothalamic-pituitary-adrenal axis activity in schizophrenic patients with positive and negative symptoms.

Hypothalamic-pituitary-adrenal (HPA) axis activity and platelet 5-HT concentrations were determined before dexamethasone suppression test (DST) in 80 male schizophrenic patients with predominantly positive or negative symptoms. Significant differences in platelet 5-HT and no differences in baseline plasma cortisol concentrations among schizophrenic suppressors and nonsuppressors were found. A similar rate of nonsuppression (56% positive and 53% negative schizophrenic patients) was detected. Platelet 5-HT, but not plasma cortisol concentrations, could be used to differentiate positive and negative symptoms of schizophrenia.

Adult↗
PubMed1997

Positive association between the GABRA5 gene and unipolar recurrent major depression.

The gamma-aminobutyric acid (GABA) neurotransmitter system has been implicated in the pathogenesis of mood disorders. To test this hypothesis we carried out an association study between a dinucleotide repeat polymorphism in the GABAA receptor alpha 5 subunit gene and bipolar and unipolar mood disorders. Our results suggest a possible involvement of this gene in unipolar but not in bipolar disorder.

Adult↗