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Popovic B.,University of Rijeka | Quadranti N.R.,University of Rijeka | Matanovic S.M.,University Hospital Center Osijek | Matanovic S.M.,Josip Juraj Strossmayer University of Osijek | And 4 more authors.
European Journal of Clinical Pharmacology | Year: 2014

Purpose: The purpose of this study was to determine the prevalence of inappropriate prescribing to the elderly and to identify possible gender-related differences in prescribing certain potentially inappropriate medications (PIMs) to outpatients by using large administrative prescription database. Methods: Medications prescribed for elderly outpatients (≥ 65 years) in Primorsko-Goranska County, Croatia, who received five or more different drugs simultaneously in 2010, were analyzed. The prevalence of potentially inappropriate drugs prescribed to the elderly was assessed using the new comprehensive protocol developed by authors Mimica Matanović and Vlahović-Palčevski. Results: A total of 62.4 % of patients received at least one medication with unfavorable benefit/risk ratio in the elderly. Female patients were given inappropriate medications in a significantly higher percentage than men (69.3 % vs. 50.5 %; p<0.001). The average number of prescriptions for PIMs that should have been avoided with certain diseases or conditions was 0.88 per patient in the survey. The most common drug combination potentially leading to serious drug-drug interactions (DDIs) included an angiotensin-converting enzyme (ACE) inhibitor and a potassium supplement. Conclusions: Our study has shown that every tenth medication prescribed to a patient >65 years and receiving five or more drugs was potentially inappropriate. Elderly women were prescribed PIMs more often than men. Drugs of concern in female patients were benzodiazepines, antidepressants, and nonsteroidal anti-inflammatory drugs (NSAIDs). In male patients, there was a significantly higher proportion of possible interactions with warfarin, theophylline, and medications affecting the cardiovascular system, such as ACE inhibitors and amiodarone. © 2014 Springer-Verlag. Source

Radic Stojkovic M.,Ruder Boskovic Institute | Miljanic S.,University of Zagreb | Miskovic K.,Josip Juraj Strossmayer University of Osijek | Glavas-Obrovac L.,Josip Juraj Strossmayer University of Osijek | And 2 more authors.
Molecular BioSystems | Year: 2011

At submicromolar concentrations two novel phenanthridine biguanides exhibit distinctly different spectroscopic signals for dGdC and dAdT sequences, respectively, by opposite fluorimetric changes (quenching for dGdC and increase for dAdT) and especially the bis-biguanide derivative gives an opposite ICD response (negative ICD for dGC and strong positive for dAdT). This specific signalling was explained by the ability of compounds to switch the binding mode from intercalation into dGdC to minor groove binding into dAdT sequences. Both compounds bind to rArU by intercalation, yielding different fluorimetric and CD response in comparison to any of aforementioned ds-DNA. Moreover, both compounds revealed significantly higher affinity toward ds-polynucleotides in comparison to previously studied alkylamine- and urea-analogues. Furthermore, DNA/RNA binding properties of novel compounds could be controlled by pH, due to the protonation of heterocyclic nitrogen. Low in vitro cytotoxicity of both compounds against human cell lines makes them interesting spectrophotometric probes. © The Royal Society of Chemistry 2011. Source

Rados I.,University Hospital Center Osijek
Periodicum Biologorum | Year: 2011

Minimally invasive procedures in pain treatment are an important supplement to conservative pain treatments, to pharmacotherapy as well as to non-pharmacological procedures when these are insufficient as pain treatments. The level of success depends on a careful pick of patients, as well as on the skill and proficiency of the doctor performing the minimally invasive procedures. Up to this point the results of many studies on minimally invasive procedures in pain treatment have been opposed, with the epidural placement of the suringe being unsuccessful in 40% of the cases, even with an experienced anaesthesiologist performeng the procedure. Not using the flouroscope is certainly one of the reasons to such a high level of set-back. The fluoroscope, which has become a standard part of many invasive procedures, is held responsible for the greater efficiency and fewer complications during invasive procedures, all resulting in the increase of minimally invasive pain treatment procedures over all. Source

Mihanovic M.,Psychiatric Hospital Sveti Ivan | Mihanovic M.,Josip Juraj Strossmayer University of Osijek | Restek-Petrovic B.,Psychiatric Hospital Sveti Ivan | Restek-Petrovic B.,Josip Juraj Strossmayer University of Osijek | And 4 more authors.
Neuropsychiatric Disease and Treatment | Year: 2015

Background: The Sveti Ivan Psychiatric Hospital in Zagreb, Croatia, offers foster home care treatment that includes pharmacotherapy, group psychodynamic psychotherapy, family therapy, and work and occupational therapy. The aim of this study is to compare the health-related quality of life of patients with schizophrenia treated in foster home care with that of patients in standard outpatient treatment. Methods: The sample consisted of 44 patients with schizophrenia who, upon discharge from the hospital, were included in foster home care treatment and a comparative group of 50 patients who returned to their families and continued receiving outpatient treatment. All patients completed the Short Form 36 Health Survey Questionnaire on the day they completed hospital treatment, 6 months later, and 1 year after they participated in the study. The research also included data on the number of hospitalizations for both groups of patients. Results: Though directly upon discharge from the hospital, patients who entered foster home care treatment assessed their health-related quality of life as poorer than patients who returned to their families, their assessments significantly improved over time. After 6 months of treatment, these patients even achieved better results in several dimensions than did patients in the outpatient program, and they also had fewer hospitalizations. These effects remained the same at the follow-up 1 year after the inclusion in the study. Conclusion: Notwithstanding the limitations of this study, it can be concluded that treatment in foster home care is associated with an improvement in the quality of life of patients with schizophrenia, but the same was not observed for the patients in standard outpatient treatment. We hope that these findings will contribute to an improved understanding of the influence of psychosocial factors on the functioning of patients and the development of more effective therapeutic methods aimed at improving the patients’ quality of life. © 2015 Mihanović et al. Source

Luksic I.,University of Zagreb | Suton P.,University of Zagreb | Macan D.,University of Zagreb | Dinjar K.,University Hospital Center Osijek
British Journal of Oral and Maxillofacial Surgery | Year: 2014

Adenoid cystic carcinoma is the most common malignancy of the minor salivary glands, and its biological behaviour is characterised by slow and indolent growth; rare involvement of regional lymph nodes; a high propensity for perineural invasion; multiple or delayed recurrences, or both; and a high incidence of distant metastases. Our aim was to find out the relation between the presence of perineural invasion and these factors. Between 1 January1984 and 1 May 2008, 26 cases of adenoid cystic carcinoma of the intraoral salivary glands, which had initially been treated surgically, were reviewed retrospectively. The most common site was the palate, and perineural invasion was reported in 13 of the 26 resected specimens. There was no significant association between it and the size of the primary tumour (OR = 1.0; p = 1.00), invasion of the surgical margins (OR = 2.08; p = 0.4), the presence of distant metastases (OR = 3.43; p = 0.197), or local control (p = 0.76). It was exclusively present in patients with local extension, and was significantly associated with outcome (p = 0.04). Resection with clear margins is the gold standard of care for patients with intraoral adenoid cystic carcinoma, and the role of adjuvant irradiation remains controversial. Given its paradoxical and complex biological behaviour, large studies with long term follow-up are needed to define the clinicopathological and immunohistochemical variables associated with outcome, as well as the optimal treatment. © 2013 The British Association of Oral and Maxillofacial Surgeons. Source

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