Repetitive suicide attempts by poisoning in Vojvodina, Serbia - Psychotropic drugs as main causes.

OBJECTIVE: Repetitive acute self-poisoning takes great part of all admissions at the Emergency Department including self-harm as one of the main reasons. The aim of this study is to analyze the characteristics of the patients treated for repetitive self-poisoning with suicidal intent (RSP-SI) in Vojvodina (Serbia), in order to propose preventative strategy and better management of the issue. PATIENTS AND METHODS: The retrospective study included data regarding patients treated for RSP-SI during a 5-year period in Vojvodina, Serbia. RESULTS: Repetitive self-poisoning was determined in 485 patients, of whom 35.05% reported suicidal intention. Mean number of RSP-SI per patient was 3.61±3.08. The mean period between two RSP-SI in group of females and males was 9.69±13.60 and 6.95±11.02 months, respectively. Almost two thirds (65.29%) of them were unemployed. Most of the patients had mental and behavioral disorders due to psychoactive substance use (ICD F10-19; 51.18%) and anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (ICD F40-48; 33.53%). The sole etiological agent was identified in 39.15% attempts. In 58.08% of the attempts more than one substance was detected (2.50±0.73 per attempt). The co-ingestion of alcohol and benzodiazepines was the most common combination (19.41%). Psychiatry intervention was needed in 70.31% of the patients. Five of all patients with RSP-SI (2.94%) committed suicide. CONCLUSIONS: The recognition and the treatment of mental disorders as well as the control of psychiatric medications prescribing could represent one of the most important preventive strategies for repetitive suicidal behavior.

Disorder verbal memory in alcoholics after delirium tremens.

AIMS: Alcohol delirium tremens suggests dysfunction of numerous brain regions. Several Authors suggest that alcohol and withdrawal from alcohol could cause neurotoxic lesions in the frontal lobe and thereby affect cognitive function. However, it is not that well known whether the consequences of the damage following delirium are only quantitative or qualitative. PATIENTS AND METHODS: Thirty alcohol-dependent patients after alcohol delirium (ADT-n1 = 30), and 30 alcohol-dependent patients without alcohol delirium (ALC-n2=30) were compared with neuropsychological test-battery. [(Wechsler Bellevue Intelligence Scale - WB form I, Wechsler memory scale and Rey Auditory Verbal Learning Test (RAVLT)]. Examinees were selected as equivalent pairs, in such a manner that they were of approximately same age, i.e. age difference was 0-5 years, they were of the same education level, and difference in the duration of drinking was not more than 3 years. RESULTS: In the group of ADT patients, IQ was 97.53, while it is 109.53 for ALC patients. Mental deterioration of the examined group is 40, and in the control group 13. Group of ADT patients had significantly lower achievements on subtests: arithmetic, block design and digit symbol. ADT patients' average memory quotient (MQ) is 81.8, which is three standard deviations lower compared to ALC patients (MQ 102.2) and standard values, according to Wechsler. In the first repetition of the series of 15 words RAVLT, is no difference (t-test=1.88; p > 0.05), while the difference in other repetitions is significant. Difference is also statistically significant regarding recollection after 30 minutes (t-test=3.66; p < 0.05). CONCLUSION: There is qualitative difference in cognitive deficiencies in alcoholics with delirium tremens and those with no alcohol delirium, while the predominant pathology of the cognitive-amnestic deficiency is in compliance with the dysfunction of the prefrontal lobe. Following alcohol delirium, verbal memory disorders occur within the intellectual decrease and attention disorder in general.

The impact of heroin on visual memory.

INTRODUCTION AND AIM: Heroin abuse can lead to organic damage of cerebral structures, including sequels in cognitive and affective sphere, which are in positive relation with the duration of substance usage. Memory is one of the cognitive functions which is highly sensitive to opiate toxic effects. The aim of this research was determination of heroin impact on the visual memory of addicts, as well as the existence of specific relation of potential deficiencies in visual memory with the duration of substance use. METHODS: The research included 90 examinees, divided into three groups, depending on the duration of heroin intake. We used questionnaire for basic socio-demographic and addictological traits of examinees; Wechsler's scale for the assessment of the intelligence and Visual Memory Test (TVP), for the assessment of the visual memory. RESULTS: The achievements of heroin addicts with different duration of the substance abuse differ significantly (F = 1.83; df = 12; p < 0.05). Total number of errors examinees make in the first series of TVP (immediate visual memory) grows, almost linearly in the function of the duration of heroin abuse (p < 0.05), but in neither of groups meets criteria for the visual memory impairment. Deficiency of the delayed visual memory occurs in examinees who use heroin for one (total number of errors = 6.46; participation of typical organic errors = 31.7%) and longer than five years (total number of errors = 7.66; participation of typical organic errors = 26.7%). Univariate covariance analysis separates the average daily dosage of heroin as the most significant variable that contributes to the expression of the aforementioned deficiencies (F = 4.21; df = 2; p < 0.05). CONCLUSION: Heroin abuse leads to damage of delayed visual memory, whereby for the observed effect intake of the substance for a period longer than one year is necessary.

The issue of applying marketing on the pharmaceutical market in Serbia.

The issue of applying marketing on the pharmaceutical market has the features of subject-based approach, with the intention to appreciate the specific nature of the products, as well as the special characteristics of the complexly formed demand. The relevance of the issue is related to the above-average performance of the pharmaceutical industry, its role in the generation of humanity's demographic transition, and specific development routes of marketing as a scientific and practical discipline. The sensitive nature of a pharmaceutical product on the one hand generates the intense legislation on this market, whereas on the other, the circumstances of its use generate a specific environment in which the production/consumption of the products of pharmaceutical industry is intensively reflected as a specific medical, cultural, economic and even political phenomenon.

[A manic syndrome after cerebral trauma: case report]. / Manicni sindrom nakon cerebralne traume: prikaz slucaja.

This case report describes a 17-year-old female patient in whom a clinical picture of manic syndrome developed four days after craniocerebral trauma. The diagnostic procedure comprised neuropsychological, neurophysiological and neuroanatomical examination. The diagnosis revealed discrete organicity on the level of psychic functions, whereas magnetic resonance imaging revealed changes of the right hemisphere. One case cannot reveal the etiology of affective disorders after cerebral injuries, but gathered results point to the possibility of causal connection between craniocerebral trauma and manic syndrome.