scholarly journals FEATURES OF ADDICTIVE PERSONALITY

2019 ◽  
pp. 55-60
Author(s):  
Eduard Krainikov ◽  
Eugeniy Prokopovich ◽  
Аlona Balanyuk
Keyword(s):  
Computer Games ◽  
Clinical Manifestations ◽  
Assessment Tools ◽  
Anxiety And Depression ◽  
Economic Damage ◽  
P Value ◽  
The Troubles ◽  
Computer Addiction ◽  
Addictive Personality ◽  
Depressive Personality

We surveyed 50 people between the ages of 18 and 25, most of respondents are college students. We used the following assessment tools: SMOL (abbreviated adaptation of MMPI), Heim's test for coping strategies, Mendelevich's methodic, Michigan Alcohol Test (MAST), Urgent Dependence Questionnaire in Shibko's adaptation. Respondents show some signs of predisposition, or even a clear presence of addictive behavior. Choosing a way to escape from reality was a cultural phenomenon, that is, the choice of an addictive agent is more dictated by advertising, public opinion, and art products. This data confirms the close direct relationship between alcohol dependence (according to MAST) and psychopathy — a correlation coefficient of 0.27. According to the regression analysis, the data of this scale strongly depend on the indicators of the hysteria scale (P-value = 0.01). This indicates that expressing alcohol and the consequences of such abuse can make a person protesting, uncomfortable, and seeking to exaggerate their problems and attract attention. The results of the study confirmed the literature data about self-centered, depressive, and anxious fetures of addictive personality. We can assume that the higher the emotional lability, anxiety and depressive personality, the greater the likelihood of addiction to computer games. It is worth noting that this dependency is different from the other vivid virtual world, which gives the person the opportunity to hide in him from the troubles. For people with adaptation disorders and computer addiction, clinical manifestations of anxiety and depression, severe depressive and anxiety episodes are common; high levels of situational and personal anxiety, excessive nervous and mental stress. That is, we can conclude that both computer addiction and gaming addiction are strongly linked to anxiety and depression. We assume that these dependencies are very closely related and that it is difficult to draw a clear boundary. In addition to health problems, psychoactive substance use, and addiction to procedural addiction, it causes significant social and economic damage to individuals and society as a whole.

scholarly journals Clinical-pathopsychological and psychodiagnostic specifics of comorbid adaptation disorders in people with computer addiction

2019 ◽  
Vol 85 (4) ◽  
pp. 101-106
Author(s):  
Yu. Starodubtseva
Keyword(s):  
Family Relationships ◽  
Clinical Manifestations ◽  
Anxiety And Depression ◽  
Control Group ◽  
Way Of Life ◽  
Computer Addiction ◽  
Comprehensive Survey ◽  
Personal Anxiety ◽  
Tunnel Syndrome ◽  
High Level

The clinical-psychopathological and psychodiagnostic features of adaptation disorders combined with computer addiction were studied. A comprehensive survey of 97 people with adaptation disorders and clinically pronounced computer addiction (main group) and 62 patients with adaptation disorders without signs of addictive behavior (control group) were carried out. It was established that the clinical picture of adaptation disorders with comorbid computer addiction was characterized by depressive, anxiety, obsessive, asthenic, dysphoric, and somatic-vegetative syndrome complexes, 35.8 % of patients had carpal tunnel syndrome. Clinical manifestations of anxiety and depression on the Hospital scale, severe depressive and anxiety episodes on the Hamilton scale, high levels of situational and personal anxiety on the Spielberger–Hanin scale, excessive mental stress on the Nemchin scale are typical for people with adaptation disorders and computer addiction. It was shown that the key role in the pathopsychological mechanisms of comorbid adaptation disorders with computer addiction belongs to the de-actualization of basic personality needs, instability of the level of requirements, the dominance of game motives, the use of coping strategies aimed at distraction and emotion, application of a strategy of behavior in the form of avoidance and adaptation in a conflict situation, high level of social frustration in the areas of their own way of life, family relationships, relationships at work and the content of their work.

scholarly journals Comprehensive approach to therapy of adaptation disorders associated with computer addiction

2019 ◽  
Vol 25 (3) ◽  
pp. 155-159
Author(s):  
Yu. A. Starodubtseva
Keyword(s):  
Computer Games ◽  
Rating Scale ◽  
Anxiety And Depression ◽  
Control Group ◽  
Emotional Status ◽  
Educational Work ◽  
Comprehensive Program ◽  
Therapy Program ◽  
Computer Addiction ◽  
Anxiolytic Drugs

Background. In modern conditions there is a quick increase in non-chemical addictions, primarily computer addiction. Unfortunately, patients with non-chemical addictions do not fall into the field of view of doctors at the early stages of the development of the disease. They seek specialized help when addiction becomes a chronic process; due to disability, and delinquent behavior, which contributes to a violation of social functioning and quality of life of the patient and his family. Objective – to develop and evaluate the effectiveness of a comprehensive program for the treatment of adaptation disorders associated with computer addiction, based on the study of clinical, psychopathological and pathopsychological patterns of their formation. Materials and methods. The study involved 117 patients with signs of computer addiction according to the results of AUDIT-like tests and with adaptation disorders. The main group consisted of 66 patients who took part in the complex therapy program using the methods of pharmacotherapy, psychotherapy and psycho-education; control group – 51 patients who received standard regulated therapy in a medical institution. We used such study methods: clinical-anamnestic; clinical-psychopathological, using AUDIT-like tests for a comprehensive assessment of addictive status, psychodiagnostic using a hospital scale of anxiety and depression, Hamilton anxiety rating scale, Hamilton depression rating scale, the questionnaire of neuro-psychic tension according to T. A. Niemchyn; statistical. Results. The clinical picture of computer addiction noted: compulsive surfing in a computer network (45.8±1.6% of the examined), computer games (22.3±1.2%), virtual communication (5.8±0.4%), gambling on-line (14.1±1.1%), passion for porn sites (1.2±0.1%). All examined patients received pharmacotherapy – antidepressants (SSRI) and anxiolytic drugs. and anxiolytic drugs. The psychotherapeutic complex included the use of rational psychotherapy, personality-oriented psychotherapy, existential psychotherapy, art therapy (painting technique). Psycho-educational work included the use of information modules, motivational trainings, the formation of communicative skills, problem-oriented discussions and teaching coping skills. Psychotherapeutic and psycho-educational work was aimed at determining the patient’s resource in overcoming computer addiction and its occurrence. Due to effects of the developed comprehensive program for the treatment of adaptation disorders associated with computer addiction, positive dynamics of the emotional status of patients were achieved, reduction of manifestations of anxiety and depression by HADS, reduction of manifestations of severe depressive and anxious episodes according to the Hamilton scales as well as reduce neuropsychic stress on a scale of T. A. Niemchyn were indicated. Conclusions. A comprehensive system for the treatment of adaptation disorders associated with computer addiction should include a combination of pharmacotherapy, psychotherapy and psycho-education. Positive dynamics of the emotional status of patients, the predominance of subclinical manifestations or the absence of anxiety and depression on the HADS scale; mild depressive and anxious episodes or their absence according to the HAM-D and HAM-A scales; reduction of neuropsychic stress on a scale of T. A. Niemchyn as well as stability of the therapeutic effect during a two-year follow-up study indicates the effectiveness of the developed comprehensive therapy program.

scholarly journals CLINICAL PHENOMENOLOGY OF ADAPTATION DISORDERS IN PEOPLE WITH COMPUTER DEPENDENCY

2018 ◽  
Vol 5 (4) ◽  
pp. 188-190
Author(s):  
Yu. Starodubtseva
Keyword(s):  
Psychological Stress ◽  
Computer Games ◽  
Clinical Manifestations ◽  
Main Group ◽  
Online Gambling ◽  
Anxiety And Depression ◽  
Clinical Image ◽  
Control Group ◽  
Clinical Phenomenology ◽  
High Level

CLINICAL PHENOMENOLOGY OF ADAPTATION DISORDERS IN PEOPLE WITH COMPUTER DEPENDENCYStarodubtseva Yu.The purpose of the study was comprehensive study of clinical-psychopathological and pathopsychological peculiarities of adaptation disorders in persons with computer dependence. 147 patients with adaptive disorders (F43.21, F43.22). The main group consisted of 85 patients with signs of computer dependence according to the results of AUDIT-like tests, the control group included 62 patients without signs of addictive behavior. The average age of the examined people was 27,0 ± 3,0 years. Clinical-psychopathological, clinical-anamnestic pathopsychological, psychodiagnostic and statistical methods were used to attain the aim.The structure of computer dependence in the surveyed people of the main group consisted of obsessive surfing (46.2%); computer games (22.3%); virtual dating (6.4%); passion for online gambling (13.7%); cybersex (1.4%). In clinical adaptation disorders, people with computer dependence are dominated by reduced mood; internal stress with inability to relax; increased susceptibility to previously neutral stimuli; irritability; asthenic symptoms; loss of interest in work or study, family and friends; violation of the sleep-wake cycle. According to the psychodiagnostic survey data, the examined people of the main group are characterized by anxiety and depression manifestations by the Hospital scale; severe depressive and anxiety episodes by the Hamilton scale; high levels of situational and personal anxiety by the method of Ch. D. Spielberger, high level of expressiveness of the psychological stress by the scale of T. A. Nemchin. It was concluded that the clinical image of adaptation disorders in persons with computer dependence is characterized by reduced mood background; predilection, predisposition to affectus; alarming manifestations; hyperesthesia; violation of the sleep-wake cycle; clinical manifestations of anxiety and depression by the HADS scale; heavy depressive and anxious episodes by the HDRS scale; high levels of situational and personality anxiety; excessive psychological stress.Key words:adaptation disorders, computer dependence, anxiety, depression, psychological stress, asthenia. РезюмеКЛІНІЧНА ФЕНОМЕНОЛОГІЯ РОЗЛАДІВ АДАПТАЦІЇ У ОСІБ З КОМП’ЮТЕРНОЮ ЗАЛЕЖНІСТЮСтародубцева Ю.З метоюкомплексного вивчення клініко-психопатологічних та патопсихологічних особливостей розладів адаптації у осіб з комп’ютерною залежністю147 хворих з розладами адаптації (F43.21, F43.22) було обстежено з використанням клініко-психопатологічного, клініко-анамнестичного, патопсихологічного, психодіагностичного та статистичногометодів  обстеження. Основну групу склали 85 хворих з ознаками комп’ютерної залежності за результатами AUDIT-подібних тестів, контрольну - 62 хворий без ознак залежної поведінки. Середній вік обстежених склав 27,0±3,0 роки.Структуру комп'ютерної залежності у обстежених основної групи склали: нав'язливий серфінг (46,2 %), комп'ютерні ігри (22,3 %), віртуальні знайомства (6,4%), пристрасть до онлайнових азартних ігор (13,7 %), кіберсекс (1,4 %). У клінічних розладах адаптації у осіб з комп’ютерною залежністю домінують пригніченість настро, внутрішня напруга з неможливістю розслабитися, підвищена сприйнятливість до раніше нейтральних подразників, дративлівість, астенічні симптоми, втрата інтересу до роботи або навчання, сім’ї та друзів, порушення циклу сон-неспання. За даними психодіагностичного обстеження у обстежених основної групи відмічалися клінічні прояви тривоги та депресії за Госпітальною шкалою; важкийдепресивний та тривожний епізоди за шкалою Гамільтона; високі рівні ситуативної й особистісної тривожності за методикою Ч. Д. Спілбергера, високій рівень виразності нервово-психічної напруги по шкалі Т. А. Немчина.Встановлено, що для клінічної картини розладів адаптації у осіб з комп’ютерною залежністю притаманні знижений фон настрою,  дративлівість, схильність до афекту, тривожні прояви, гіперстезії, порушення циклу сон-неспання, клінічні прояви тривоги та депресії за шкалою HADS,важкі депресивні та тривожні епізоди за шкалою HDRS; високі рівні ситуативної та особистісної тривожності, надмірна нервово-психічна напруга.Ключові слова: розлади адаптації, комп’ютерна залежність, тривога, депресія, нервово-психічна напруга, астенія. РезюмеКЛИНИЧЕСКАЯ ФЕНОМЕНОЛОГИЯ РАССТРОЙСТВ АДАПТАЦИИ У ЛИЦ С КОМПЬЮТЕРНОЙ ЗАВИСИМОСТЬЮСтародубцева Ю.С целью комплексного изучения клинико-психопатологических и патопсихологических особенностей расстройств адаптации у лиц с компьютерной зависимостью обследовано 147 больных с расстройствами адаптации (F43.21, F43.22) с использованием клинико-психопатологического, клинико-анамнестического, патопсихологического, психодиагностического и статистического методов обследования. Основную группу составили 85 больных с признаками компьютерной зависимости по результатам AUDIT-подобных тестов, контрольную - 62 больных без признаков зависимого поведения. Средний возраст обследованных составил 27,0 ± 3,0 года.Структуру компьютерной зависимости у обследованных основной группы составили: навязчивый серфинг (46,2%), компьютерные игры (22,3%), виртуальные знакомства (6,4%), страсть к онлайновых азартных игр (13,7%), киберсекс (1,4%). В клинической картине расстройств адаптации в лиц с компьютерной зависимостью доминируют подавленность настроения, внутреннее напряжение с невозможностью расслабиться, повышенная восприимчивость к ранее нейтральным раздражителям, раздражительность, астенические симптомы, потеря интереса к работе или учебе, семье и друзьям, нарушения цикла сон-бодрствование. По данным психодиагностического обследования у обследованных основной группы отмечались клинические проявления тревоги и депрессии с Госпитальной шкале; тяжелый депрессивный и тревожный эпизоды по шкале Гамильтона; высокие уровни ситуативной и личностной тревожности по методике Ч. Д. Спилбергера, высокий уровень выраженности нервно-психического напряжения по шкале Т. А. Немчина.Установлено, что для клинической картины расстройств адаптации у лиц с компьютерной зависимостью присущи пониженный фон настроения, раздражительность, склонность к аффектам, тревожные проявления, гиперестезия, нарушения цикла сон-бодрствование, клинические проявления тревоги и депрессии по шкале HADS, тяжелые депрессивные и тревожные эпизоды по шкале HDRS, высокие уровни ситуативной и личностной тревожности, чрезмерное нервно-психическое напряжение.Ключевые слова:расстройства адаптации, компьютерная зависимость, тревога, депрессия, нервно-психическое напряжение, астения.

scholarly journals EFEKTIFITAS TERAPI DEKAPAN IBU TERHADAP PENURUNAN INTENSITAS NYERI PADA BAYI YANG MENJALANI IMUNISASI

2021 ◽  
Vol 10 (1) ◽  
pp. 51
Author(s):  
Fiki Wijayanti ◽  
Natalia Devi Oktarina
Keyword(s):  
Pain Assessment ◽  
T Test ◽  
Assessment Tools ◽  
Control Group ◽  
P Value ◽  
Control Group Design ◽  
Purposive Sampling ◽  
Group Design ◽  
Post Test ◽  
Test Control

ABSTRAK Imunisasi merupakan salah satu cara memberikan kekebalan tubuh pada anak untuk mencegah penyakit. Pemberian imunisasi melalui suntikan dapat menimbulkan efek secara langsung yaitu rasa nyeri pada anak. Nyeri yang disebabkan oleh suntikan imunisasi jika tidak dikelola akan mengakibatkan dampak negatif pada aspek emosional pada anak seperti menangis dan ketakutan. Salah satu intervensi yang dapat dikembangkan dalam menerapkan perawatan atraumatik saat pemberian imunisasi pada anak adalah terapi dekapan ibu. Tujuan dalam penelitian ini adalah untuk menganalisis efektifitas terapi dekapan ibu terhadap nyeri pada bayi yang dilakukan imunisasi di Puskesmas Lerep. Jenis penelitian yang digunakan dalam penelitian ini adalah  Preeksperimen design dengan rancangan pretest-post test control group design. Metode Pengambilan sampling menggunakan Purposive sampling dengan jumlah sampel pada kelompok kontrol sejumlah 30 bayi dan kelompok intervensi 30 bayi. Dalam penelitian ini ada 2 variabel yang diukur yaitu variabel Nyeri dan pemberian terapi dekapan ibu. Variabel nyeri diukur menggunakan instrument FLACC Pain Assessment Tools. Sedangkan variabel terapi dekapan ibu diukur dengan melakukan observasi saat pemberian imunisai. Uji statistik yang digunakan adalah dengan  t test-independent. Hasil yang didapatkan adalah  p value 0,0001. Berdasarkan hasil analisis diketahui bahwa ada perbedaan selisih rata-rata nyeri pada kelompok intervensi dan kontrol (p<0,05). Diharapakan Tenaga Kesehatan di Puskesmas menerapkan tindakan atraumatic care pada bayi yang akan dilakukan imunisasi dengan cara mengikutsertakan ibu dalam kegiatan imunisasi yaitu dengan dekapan ibu. Kata Kunci : Nyeri, Bayi, imunisasi dan dekapan ibu

scholarly journals Correlation between Clinical Symptoms of Coeliac Disease, Serum IgA Anti TTG and Biopsy in Pediatric Population of Northern India

2020 ◽  
Vol 8 (1) ◽  
pp. 65-68
Author(s):  
Sumit Jeena ◽  
Jaswinder Kaur ◽  
Nishant Wadhwa
Keyword(s):  
Coeliac Disease ◽  
Clinical Symptoms ◽  
Tissue Transglutaminase ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
North India ◽  
P Value ◽  
Serum Iga ◽  
Significant Difference ◽  
The Mean

Background: Celiac disease is basically an immune-mediated enteropathic condition produced by permanent sensitivity to gluten in genetically susceptible subjects. There is paucity of data in north India regarding clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population. The present study was conducted with the aim to determine the correlation between clinical symptoms of coeliac disease, Serum IgA Anti TTG and Biopsy in pediatric population of northern India.Materials and Methods: The present study was conducted in prospective including 73 pediatric patients at Department of Pediatric Gastroenterology, Institute of Child Health, Sir Gangaram Hospital, New Delhi, India. Esophagogastroduodenoendoscopy and serum anti Ig A tissue transglutaminase were performed. The characteristic scalloping of the folds were looked for in endoscopy followed by four duodenal biopsies performed from second part of duodenum and histological grading was performed as per modified marsh system. Patients with Serum IgA anti tTG>20 U/ml were confirmed to be at risk. Complete histological work up was done including hemoglobin, RBC indices and peripheral blood smear examination. The association of clinical manifestations with disease grade was also established with correlation coefficient. All the data thus obtained was arranged in a tabulated form and analyzed using SPSS software. Probability value of less than 0.05 was regarded as significant.Results: There were 4 males and 16 females with marsh grade 1 and 2 and mean age of 7.3±1.9 years. There were 5 males and 8 females with marsh grade 3a and mean age of 6.8±2.3 years. The mean weight of 18.11±3.89, height of 103.17±8.73 and BMI of 16.26±3.78 was observed amongst subjects with Marsh grade 1 and 2. The mean weight of 15.12±3.17, height of 99.28±9.19 and BMI of 15.02±3.20was observed amongst subjects with Marsh grade 3a. Diarrhoea was maximum amongst subjects with grade 3c and 4(70%) and minimum amongst Grade 1 and 2 (40%). There was a significant difference between the frequency of anemia amongst different grades as the p value was less than 0.05.Conclusion: The most common presenting signs and symptoms were diarrhea and abdominal pain. The study also concluded that the incidence of anemia increases with higher marsh grades.

scholarly journals Pattern of Thyroid Cancer and Its Associated Factors Among Thyroid Patients Underwent Thyroidectomy at Jimma Medical Center, Southwest Ethiopia; A Four Years Retrospective Review

2020 ◽  
Author(s):  
Bilisuma Mulatu ◽  
Yadene Michael ◽  
Seifu Alemu ◽  
Wondu Reta Demissie
Keyword(s):  
Logistic Regression ◽  
Thyroid Cancer ◽  
Thyroid Surgery ◽  
Medical Center ◽  
Clinical Manifestations ◽  
P Value ◽  
Thyroid Function Tests ◽  
Early Screening ◽  
Thyroid Lesion ◽  
Thyroid Mass

Abstract Background: Thyroid cancer is the most common malignant disease of endocrine system and its incidence is rapidly increasing globally (about three to four times higher among females and accounts the sixth most common malignancy diagnosed in women). Among the four major types of thyroid cancer, papillary thyroid cancer (PTC) accounts 85-90% from all thyroid cases, followed by follicular thyroid cancer (FTC) which accounts for 5-10% of cases.Materials and Methods: A retrospective data of 260 patients who underwent thyroid surgery from 2015 to 2019 were included in the study and the status of the disease (clinical manifestations, laboratory/pathology findings (thyroid function tests (TFTs) and biopsy) were reviewed from patient cards. The pattern of thyroid cancer was discriminated based on histo-pathological biopsy result. Descriptive and analytical statistics were applied to express the finding and reported by tables, figures and narration. Cross tabulation and logistic regression was applied to determine the association between thyroid CA and predictors. A p-value of <0.05 was declared as statistically significant. Results: From the total sample of 260 patients underwent thyroid surgery, majority of them were females 219(84.2%), belong to age interval of 31-40 years (34.6%), dwellers of Oromia region (91.2%) and Jimma zone (83.8%). Colloid goiter was the most prevalent (74.6%) pattern of thyroid disease followed by follicular CA (4.2%), papillary CA (1.9%) and medullary CA (0.77%) while biopsy results of 48(18.46%) patients were not known. In general, about the 194(91.5%) of the thyroid lesion was identified as benign type and malignancy accounts for 18(8.5%) from the total conducted biopsy results of 212 patients. About six variables (duration of the disease, marital status, family history of the disease, nodularity, surface and border of the thyroid mass) were the candidate variables in binary logistic regression (p-value <0.25) and finally, three variables (duration of the disease (>10 years), surface (rough) and border (irregular) of the thyroid mass) were identified as the predictors of thyroid malignancy with AOR 0.05(0.004-0.60, P-v=0.016; 1.9(1.17-5.8), P-v=0.012 and 2.5(1.13-16.16), P-v<0.001 respectively.Conclusion and recommendation: The burden of malignancy was higher and alarming among thyroid diseases and warrants early screening and management.

scholarly journals 42 Training Forgiveness – A Novel Approach to Reducing Physician Burnout

CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 198-199 ◽  
Author(s):  
Lidia Firulescu ◽  
Ross W. May ◽  
Frank D. Fincham ◽  
Emelina A. Arocha ◽  
Marcos A. Sanchez-Gonzalez
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Well Being ◽  
Anxiety And Depression ◽  
P Value ◽  
Depression And Anxiety ◽  
Physician Burnout ◽  
Study Objective ◽  
Work Related ◽  
Mental And Physical Health

AbstractStudy ObjectivePsychological risk factors that lead to impaired work performance, negatively impacting mental and physical health, have emerged as a concern across clinical settings. Although depression and anxiety are linked to poor physician mental health, physician burnout characterized by work related stress due to chronic exhaustion from clinical work, cynicism toward meaning of the medical profession, and feelings of inadequacy toward work related accomplishments, may be an even stronger indicator of well-being. Literature suggests that work satisfaction among physicians is rapidly deteriorating owing to high rates of burn out and poor mental health. Although the relationship between work burnout (WB) and negative affectivity has been well documented, the association with positive affect, such as trait forgiveness (TF) has been overlooked. On that note, research shows that lifetime stress severity and lower levels of forgiveness predict worse mental and physical health. Since TF has been linked strongly with healthy workplace relationships, positive occupational outcomes and general well-being, its association with WB remains to be investigated. Therefore, the aim of the present study was to explore the link between TF and WB among physicians. We hypothesized that TF would be associated with reduced levels of burnout.MethodA total of 62 (F=23) medical residents at a Teaching Hospital consented for the study. Residents were administered surveys on WB (Maslach BurnoutInventory), workplace bullying, personal bullying (PB), interpersonal rejection sensitivity (IRS), perceived stress scale (PSS), TF, anxiety, and depression, all of which were anonymously submitted via electronically. Hierarchical multiple regression (HMR) models were used to determine the associations between WB, work environment social factors and TF. A p-value of <0.05 was considered significant.ResultsThe mean age 33.1±SD 4.2 years. HMR analysis using WB as main outcome contained 6 predictors: Model 1 contained depression and anxiety, Model 2 added PB, Model 3 added IRS and PSS, Model 4 added TF. Anxiety and TF were the only significant predictors (p= >0.05) accounting for 10.4% and 17.5% of the variance in WB scores, respectively.ConclusionsThe novel finding of the present study is that TF was associated with low levels of burnout. Additionally, WB was found to be linked to anxiety and depression which is in line with previous research. These data suggest that TF could be a potential resolution to the deleterious influence of burnout. Further exploration is needed in order to understand the psychology of forgiveness as a potential adjuvant and/or therapeutic intervention for physicians’ burnout. These results suggest that strategies including forgiveness training aimed at decreasing WB while increasing job satisfaction among physicians warrant further exploration.Funding Acknowledgements: no funding

Human Herpes Virus 6 Infection in 54 Patients after Allogeneic Hematopoietic Stem Cell Transplantation: Clinical Manifestations and Outcome

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 3899-3899
Author(s):  
Raffaella Greco ◽  
Lara Crucitti ◽  
Sara Racca ◽  
Roee Dvir ◽  
Francesca Lorentino ◽  
...  
Keyword(s):  
Overall Survival ◽  
Stem Cell ◽  
Acute Gvhd ◽  
Clinical Manifestations ◽  
Rank Test ◽  
P Value ◽  
Hematopoietic Stem ◽  
Clinical Complications ◽  
Log Rank Test ◽  
Blue Line

Abstract BACKGROUND: Human herpesvirus type 6 (HHV-6) is increasingly recognized as an opportunistic and potentially life-threatening pathogen in recipients of allogeneic hematopoietic stem cell transplantation (AlloSCT). HHV-6 is a member of the beta herpesvirus subfamily (genus Roseolovirus). HHV-6 infection is recognized as the cause of a febrile disease and exanthem subitum in early childhood. Approximately 60% of solid organ transplant and 40% of patients after alloSCT experienced HHV-6 reactivation. Reported clinical manifestations of HHV-6 infection in transplanted patients are skin rash, interstitial pneumonia, bone marrow suppression and encephalitis. Moreover, some clinical reports suggest that HHV-6 can facilitate the occurrence of severe clinical complications of alloSCT, increasing transplant-related mortality. METHODS: From January 2009 to February 2013, we retrospectively evaluated 54 consecutive adult patients (median age 50 years) who developed positivity to HHV-6 after alloSCT for high-risk hematological malignancies. Stem cell donors were family haploidentical (37), HLA identical sibling (8), unrelated volunteer (6), cord blood (3). The viral load was determined by quantitative PCR (Nanogen Advanced Diagnostic S.r.L) in cell-free body fluids such as plasma, bronchoalveolar lavage (BAL), cerebrospinal fluid (CSF), bone marrow (BM) aspirates or in gastrointestinal biopsies. RESULTS: Median time from alloSCT to HHV-6 reactivation was 34 days (range: 0-705). Thirty-one patients presented HHV-6 positive in plasma, 9/54 in BM, 33/54 in gut biopsies or BAL, 7/54 in CSF. At the time of viral positivity all pts were receiving acyclovir as viral prophylaxis except five. Twenty-nine patients had acute graft versus host disease (GvHD). Twenty-two out of these twenty-nine patients experienced a grade III-IV acute GvHD, requiring high dose steroids in twenty-six cases. A concomitant CMV positivity was detected in 15/54 patients. The median absolute count of CD3+ lymphocytes was 207 cells/mcl. In 52/54 cases we reported HHV-6 clinical manifestations: fever (43), skin rash (22), hepatitis (19), diarrhoea (24), encephalitis (10), BM suppression (18), delayed engraftment (11). HHV-6 positivity led to antiviral pharmacological treatment in 37/54 cases, using as first choice therapy foscarnet. Amongst the total fifty-four patients with documented HHV-6 positivity thirty-one solved the clinical event. However the mortality rate was relatively high in this population (overall survival (OS) ±SE at 1 year after HHV-6 reactivation was 38% ± 7%), mainly related to severe infections or GvHD. A better OS is significantly associated with CD3+ cells ≥200/mcl at the time of HHV-6 reactivation (fig 1) (OS at 1 year 63% compared to 11% for patients with CD3 <200/mcl; HR: 0.27, 95% CI 0.12-0.54, p=0.0002). The overall survival of these patients was also positively affected by the absence of acute GvHD grade III-IV at time of viral reactivation (HR: 0.03, 95% CI 1.08-4.03, p=0.03) and by the complete disease remission at time of HSCT (HR:0.26, 95% CI 0.07-0.89, p=0.03). In this analysis the overall survival was not significantly influenced by steroids administration (HR: 1.36, 95% CI 0.71-2.60, p=0.36), time after alloSCT (HR: 1.30, 95% CI 0.51-3.33, p=0.59), type of antiviral prophylaxis (HR: 1.02, 95% CI 0.45-2.33, p=0.96), plasma viral load (HR:1.18, 95% CI 0.51-2.76, p=0.69) and organ involvement (HR:1.14, 95% CI 0.59-2.20, p=0.70). CONCLUSIONS: This retrospective study confirms a correlation of HHV-6 with high morbidity and mortality rates after alloSCT, thus suggesting a regular HHV-6 monitoring in alloSCT recipients. The regular monitoring of HHV-6 DNA, using a real-time PCR assay, may be useful for identifying active HHV-6 infection and for the introduction of a pre-emptive treatment, possibly reducing the incidence of the most severe clinical complications. Despite HHV-6 detection typically occurred early after alloSCT, a better immune reconstitution has the potential to improve clinical outcome. Figure 1: Overall survival after alloSCT in HHV-6 positive patients: green line showed patients with more than 200/mcl CD3+ cells, blue line the ones with less than 200/mcl CD3+ cells at HHV-6 reactivation. P value is provided by Log Rank test. Figure 1:. Overall survival after alloSCT in HHV-6 positive patients: green line showed patients with more than 200/mcl CD3+ cells, blue line the ones with less than 200/mcl CD3+ cells at HHV-6 reactivation. P value is provided by Log Rank test. Disclosures Bonini: MolMed S.p.A.: Consultancy.

scholarly journals Treatment of Anxiety and Depression in a Patient with Brugada Syndrome

2014 ◽  
Vol 2014 ◽  
pp. 1-4
Author(s):  
Jasper J. Chen ◽  
Rajbir S. Sangha
Keyword(s):  
Brugada Syndrome ◽  
Psychiatric Symptoms ◽  
Medication Management ◽  
Clinical Manifestations ◽  
Physical Symptoms ◽  
Clinical Findings ◽  
Panic Attacks ◽  
Anxiety And Depression ◽  
Presenting Symptoms ◽  
Channel Blocking

Background. Brugada syndrome is rare and has been a clinically diagnosable entity since 1992. Its clinical manifestations are highly variable, and while some patients remain asymptomatic, others endure sudden cardiac death. Initial presenting symptoms may include palpitations, seizures, syncope, and nocturnal agonal respiration. The diagnosis of Brugada syndrome relies on both clinical findings and characteristic ECG patterns that occur spontaneously or are induced by usage of sodium-channel blocking agents.Aims of Case Report. Many psychiatrists may be unaware of the possibility of medical cocontributing etiologies to physical symptoms of anxiety and depression. We present a case of a patient who was treated psychiatrically for anxiety and panic attacks and who was subsequently diagnosed with Brugada syndrome and treated medically with an implantable cardioverter defibrillator (ICD), the only treatment option demonstrated to be effective. Her psychiatric symptoms predated her diagnosis of Brugada syndrome by at least fifteen years.Conclusion. The patient's eventual diagnosis of Brugada syndrome altered the course of her psychopharmacologic medication management and illustrates the utility of a psychosomatic approach to psychiatric symptom management.

scholarly journals Epidemiological Pattern of Poisoning in Children under the Age of 15 Admitted to the Referral Teaching Hospitals of Yazd and Taft Cities (2014-2019)

2021 ◽  
Author(s):  
Mahdieh Momayyezi ◽  
Parisa Peigan ◽  
Hossein Fallahzadeh
Keyword(s):  
Urban Areas ◽  
Pearson Correlation ◽  
Clinical Manifestations ◽  
Cross Sectional Study ◽  
Teaching Hospitals ◽  
P Value ◽  
Chi Square ◽  
Cross Sectional ◽  
Epidemiological Pattern ◽  
Poisoning In Children

Introduction: Understanding the epidemiological pattern and causes of poisoning is the first step to prevent and reduce complications and mortality due to poisoning in children. Given that no study has been conducted on this subject in Yazd, this study aimed to determine the epidemiology pattern of poisoning in children admitted to the referral teaching hospitals in Yazd and Taft cities during 2014-2019. Materials and Methods: This descriptive cross-sectional study was conducted on 238 children under the age of 15 who have been admitted to Shahid Sadoughi hospital in Yazd and Shahid Beheshti hospital in Taft city during 2014-2019. The data were analyzed by SPSS version 20.0 using descriptive statistics, Pearson correlation, and Chi-square. In all the statistical analyses, a P-value of less than 0.05 was considered significant. Results: The results showed that the frequency of poisonings was higher in girls (58%), in summer (31.1%), and in urban areas (82.8%). Most cases of poisoning aged less than 15 years (75.1%). The main cause of poisoning in children was drug poisoning (60.5%), followed by cleansing products (10.1%). The most common clinical manifestations included neurological signs (33.6%). During 2014-2019, the frequency of drugs and pesticide poisonings decreased; while poisoning due to drug-opioids and cleansing products increased (P = 0.04). Also, 3 deaths occurred due to poisoning during this period. Conclusion: The higher prevalence of drug and cleansing products poisoning in children under the age of 15 indicates involuntary poisoning in this group. Therefore, proper storage of these substances and more parental care can reduce poisonings in children.

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