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Background: The quality of life in patients undergoing hemodialysis is significantly disturbed. There are data that hemodiafiltration (HDF) may be more effective than conventional hemodialysis in the removal of uremic toxins and may reduce frequency and severity of intradialytic and postdialysis adverse symptoms in patients. Also, some researchers suggest advantages of using high-flux membranes compared with low-flux. Objective: The aim of this study was to examine whether hemodialysis modality and membrane flux, independent of membrane biocompatibility, make differences in quality of life in patients. Methods: In our cross-sectional study, we evaluated 124 patients who were divided, based on therapy, into three groups: online HDF, high-flux hemodialysis, and low-flux hemodialysis. Data were collected using the Short Form-36 questionnaire combined with special questionnaire, which included demographic and clinically related questions. Results: Health-related quality of life was better in patients on HDF compared with patients on hemodialysis, especially compared with low-flux hemodialysis patients in most of the scales and in both dimensions: physical component scale and mental component scale. There were no statistically significant differences in Short Form-36 domains between high-flux hemodialysis and low-flux hemodialysis. Conclusion: Our data suggest the potential advantages of HDF with regard to influence on quality of life, which is sufficient to justify further research in prospective and longitudinal study design.

This study indicates that different haemodialysis modalities are associated with insomnia and suggests a potential benefit of using high flux membranes.

Our results show that erythrocyte SOD activity is increased in the early phase of schizophrenia and that depends on age of onset of the disease, the number of psychotic episodes, the duration of the disease and medical treatment.

UVODProces odabira odgovarajućeg fakulteta najčešće je odraz ličnih interesovanja i afiniteta pojedinca. Ako se tome pridoda i proces selekcije koju vrše fakulteti prilikom upisa, na osnovu dotadašnjeg uspeha u školi i znanja pokazanog na prijemnom ispitu, zaključuje se da fakultet upisuju najsposobniji kandidati, sa solidnim predznanjem iz odgovarajućih oblasti, vođeni sopstvenim željama. Na osnovu ovih karakteristika, sa psihološkog aspekta, vreme studiranja se može posmatrati kao period posvećenosti ciljevima, ispunjenosti i lične izgradnje. Nažalost, studiranje može da ima i negativan uticaj na psihičko zdravlje studenata. Postojeći podaci ukazuju na to da depresija i drugi mentalni poremećaji predstavljaju sve veći zdravstveni problem u studentskoj populaciji (1-3).Prema dosadašnjim saznanjima, studenti medicine su posebno opterećeni (4). Studije medicine su napornije i traju duže nego na ostalim fakultetima, a studenti se češće suočavaju sa egzistencijalnim pitanjima kao što su patnja i umiranje. Visoka stopa depresivnosti među studentima medicine je dokumentovana u većem broju studija iz različitih zemalja (5-18).Studenti i mladi lekari koji stažiraju takođe su podložniji pojavi depresije u odnosu na opštu populaciju istog godišta pri čemu se stopa depresivnosti znatno povećava sa vremenom provedenim na stažu (19-23). Ovaj problem ne prestaje ni sa početkom profesionalne karijere tako da se beleži relativno visoka prevalenca depresije i kod lekara (24), neretko komplikovana zloupotrebom droga (6) i povećanim rizikom za suicid (25,26

AbstractThe prevalence of insomnia is greater in end-stage renal disease. The aim of our study was to determine the frequency of insomnia and subclinical insomnia in patients with various dialysis therapy and kidney transplant recipients, in order to assess the severity of insomnia and examine whether there is a difference in severity among groups. In cross-sectional study, we evaluated 120 patients with terminal renal failure. Based on therapy, patients were divided into four groups: hemodiafiltration, standard bicarbonate dialysis, peritoneal dialysis and kidney transplant recipients. The severity of insomnia was evaluated through the use of the Insomnia Severity Index (ISI). Most patients who reported any kind of insomnia problems with ISI were on conventional dialysis (80%), followed by hemodiafiltration (76.7%) and peritoneal dialysis (63.3%). Transplant recipients had least difficulties with insomnia (46.7%). Insomnia Severity Index showed that insomnia in end-stage renal patients is not very severe. Most of the patients had “no clinically significant insomnia”. Our findings indicate that patients on hemodiafiltration and transplant recipients have a significantly lower score on Insomnia Severity Index. Patients with end-stage renal disease have high frequency insomnia problems. However, our study shows that insomnia in these patients is not severe. Insomnia is the most frequent and severest in patients on standard bicarbonate dialysis.

SummaryBackgroundBrain-derived neurotrophic factor (BDNF) and nitric oxide (NO) play multiple roles in the developing and adult CNS. Since BDNF and NO metabolisms are dysregulated in schizophrenia, we measured these markers simultaneously in the blood of schizophrenics and assessed their diagnostic accuracy.MethodsThirty-eight patients with schizophrenia classified according to demographic characteristics, symptomatologyand therapy and 39 age- and gender-matched healthy controls were enrolled. BDNF was determined by the ELISA technique while the concentration of nitrite/nitrate (MJX-TeXAtom-ORDNO2−MJX-TeXAtom-ORD/MJX-TeXAtom-ORDNO3−) was measured by the colorimetric method.ResultsSerum BDNF levels were significantly lower (20.38±3.73 ng/mL, P = 1.339E-05), whilst plasma MJX-TeXAtom-ORDNO2−MJX-TeXAtom-ORD/MJX-TeXAtom-ORDNO3− concentrations were significantly higher (84.3 (72–121) μmol/L, P=4.357E-08) in patients with schizophrenia than in healthy controls (25.65±4.32 ng/mL; 60.9 (50–76) μmol/L, respectively). The lowest value of BDNF (18.14±3.26 ng/mL) and the highest MJX-TeXAtom-ORDNO2−MJX-TeXAtom-ORD/MJX-TeXAtom-ORDNO3− concentration (115.3 (80–138) μmol/L) were found in patients treated with second-generation antipsychotics (SGA). The patients diseased before the age of 24 and the patients suffering for up to one year had significantly lower serum BDNF levels than those diseased after the age of 24 and the patients who were ill longer than one year. Both BDNF and MJX-TeXAtom-ORDNO2−MJX-TeXAtom-ORD/MJX-TeXAtom-ORDNO3− showed good diagnostic accuracy, but BDNF had better ROC curve characteristics, especially in patients with negative symptomatology.ConclusionsBDNF and nitrite/nitrate showed inverse changes in schizophrenic patients. The most pronounced changes were found in patients treated with second-generation antipsychotics. Although BDNF is not specific of schizophrenia, it may be a clinically useful biomarker for the diagnosis of patients expressing predominantly negative symptoms.

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