Complex regional pain syndrome type I in the upper extremity - how efficient physical therapy and rehabilitation are.

AIM: To evaluate the effects of early started combined therapy in Complex Regional Pain Syndrome-1 (CRPS-1) on the upper extremities. METHODS: The study included 36 patients in the first stadium of CRPS-1 on the upper extremities The mean age of patients was 42.6±14.6, the majority of them (26 of 36) were females. The right side of the upper extremity was affected much more then the left side. They were treated by combined therapy including analgetics, electrotherapy, magneto therapy and kinesitherapy. The average length of observation was 172.1 days (from 90 to 250 days). The average length of treatment was 91.5±42.16 days. Intensity of pain, swelling of the extremity, the change in skin coloration and cutaneous manifestations were assessed three times, at the beginning of the treatment, after 6 weeks and at the end of the treatment. RESULTS: The pain was registered in all patients at visit 1 (average pain intensity was 5.70 ±1.44 on 100 mm visual analogue scale), and it was progressively decreased during the treatment from 3.60±1.22 at the second visit to 0.34±0.68 at the third visit. Vasodilatation was registered in 30 (83.33%) patients and skin temperature asymmetries was found in 21 (58.33%) patients. The difference of size was detected in 30 (83.33%) patients at the first visit compared to four (11.11%) patients at the end of the treatment. There were six (16.66%) patients without swelling at the beginning compared to 26 (72.22%) at the end of the treatment (p less than 0.000). Complete healing was achieved in 32 patients (88.88%). CONCLUSION: The carefully chosen physical agents in combination with analgesic and non-steroidal anti-inflammatory drugs may benefit in patients with CRPS-1 on the upper extremity if the treatment starts as soon as possible.

Epidemiological characteristics of suicidal patients admitted to the Psychiatric Clinic in Kragujevac: a ten-year retrospective study.

INTRODUCTION: Suicide attempts are a significant public health problem. They are associated with significant morbidity and result in significant use of health care resources. OBJECTIVE: The aim of our study was to analyze epidemiological characteristics attempts of suicide for persons in the period 2001-2010 who were hospitalized at the Psychiatric Clinic in Kragujevac after the attempt of suicide. METHODS: We analysed 286 clinical records of patients who had attempted suicide (133 males, 153 females). We used the illness history of patients, who were treated at the Psychiatric Clinic in Kragujevac after their suicide attempts. We made the analysis of socio-demographic characteristics of the sample and characteristics of the suicide act itself. RESULTS: Our results showed a higher rate of female population, except for the period 2003-2005:2003 - 14 males (58.3%), 2004 - 15 (62.5%) and 2005 - 60%. The largest number of attempts was in the population aged between 25 and 34 years (23.8%). The percentage of persons from urban areas was higher (66.4%). Depressive disorder was a common pre-existing disorder before a suicide attempt (42.3%). Most attempts of suicide were performed by overdosing on medications (57.7%). CONCLUSION: In the last three years we observed a decrease of suicide attempts. We noticed that middle aged persons are the most frequent ones to attempt suicide. Depressive disorder is the most frequent pre-existing condition of suicide attempt. In order to prevent suicide attempts we must improve early detection of depressive disorder, as well as initial treatment.