Croatian medical journal
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Croatian medical journal · Aug 2008
EditorialPsychopharmacotherapy of posttraumatic stress disorder.
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that develops after a psychological trauma usually caused by a situation perceived as deeply threatening to a person's life or integrity. Complex neurobiological changes triggered by such a traumatic and stressful experience may explain a wide range of PTSD symptoms and provide the rationale for psychopharmacological treatment. Selective serotonin-reuptake inhibitors make the first-line treatment of PTSD. ⋯ Other groups of medications, such as serotonin agonists and antagonists, new antidepressants, dual inhibitors of serotonin- and noradrenalin-reuptake, anticonvulsants, and opiate antagonists are also sometimes used in PTSD treatment. However, as shown in the present review, most clinical studies performed to date to investigate the effectiveness of different psychopharmacological agents in the therapy of PTSD have serious limitations in terms of small sample size, lack of blinding and randomization, and small effect size. More rigorously designed, comparative studies are needed to determine the usefulness, efficacy, tolerability, and safety of particular psychopharmaceutical drugs in the treatment of this therapeutically and functionally challenging disorder.
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Croatian medical journal · Jun 2008
Scaling-up undergraduate medical education: enabling virtual mobility by online elective courses.
To evaluate online elective courses at Croatian medical schools with respect to the virtual mobility of national teachers and students and virtual team collaboration. ⋯ Elective e-courses may be a successful model of how faculty and students at higher education institutions can collaborate and integrate e-learning into their current curricula.
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Croatian medical journal · Jun 2008
Reducing bias from test misclassification in burden of disease studies: use of test to actual positive ratio--new test parameter.
To address the problem of estimating disease frequency identified by a diagnostic test, which may not represent the actual number of persons with disease in a community, but rather the number of persons who tested positive. Those two values may be very different, their relationship depending on the properties of the diagnostic test applied and true prevalence of the disease in a population. ⋯ Optimal screening test characteristics for use in a population-based survey are likely to be different to those when the test is used in a clinical setting. Calibrating the test a priori to bring the TAP ratio closer to unity deals with the possible large bias in disease burden estimates based on application of diagnostic (screening) test.
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Croatian medical journal · Jun 2008
Influence of urbanization level and gross domestic product of counties in Croatia on access to health care.
To examine the association of counties' urbanization level and gross domestic product (GDP) per capita on the access to health care. ⋯ The lack of physicians, especially in primary health care can lead to a reduced access to health care and increased workload of physicians, predominantly in rural counties, regardless of the counties' GDP.