Panic Attacks in Patients with Supraventricular Tachycardia: Problems of Differential Diagnosis and Impact on Quality of Life

Aim. To study the psychosomatic relationships and quality of life (QOL) of patients with paroxysmal supraventricular tachycardia (SVT) depending on the presence or absence of panic attacks (PA) in comparison with patients with heartbeat against the background of somatoform autonomic dysfunction.Material and methods. The study included patients with SVT and heart attacks due to sinus tachycardia in the context of somatoform autonomic disorder (SAD). All patients were interviewed to identify anxiety and depressive disorders (Hospital Anxiety and Depression Scale [HADS] and Hamilton's Depression Scale), QOL assessment (SF-36 questionnaire), and they were also consulted by a psychiatrist who established the presence or absence of PA. According to a visual analogue scale, in points from 0 to 6, we assessed the general state of our patients' health (0 points corresponded to complete health, and 6 points corresponded to a serious illness) and the effect of heartbeat on well-being (0 points - no arrhythmia, 6 points - arrhythmia «nterferes with life»).Results. The study included 96 patients: 60 with SVT (21 men, 39 women, average age was 51 [33; 61] years) and 36 with heart attacks caused by sinus tachycardia in the framework of somatoform autonomic disorder (10 men, 26 women, average age was 33 [27; 41] years). Panic disorder was diagnosed in the SVT group in 17 patients, accounting for 28.3%. Only 7 patients (41%) could clearly differentiate between SVT and PA attacks. The low sensitivity of the HADS questionnaire in patients with SVT determined the need to consult a psychiatrist for the diagnosis of panic disorders.Conclusion. PA is typical for 28.3% of patients with SVT. The combination of SVT with PA reduces the QOL of patients due to its mental components, including due to the more frequent occurrence of depressive symptoms. Patients with SAD subjectively perceive the heartbeat as a more significant factor affecting health, compared with patients with SVT. Difficulties in the differential diagnosis of PA and SVT paroxysms in real clinical practice often lead to the appointment of the same therapy without taking into account the differences in the genesis of heartbeats.

Anti-Inflammatory Effects of Heliangin from Jerusalem Artichoke (Helianthus tuberosus) Leaves Might Prevent Atherosclerosis

Atherosclerosis is considered the major cause of cardiovascular and cerebrovascular diseases, which are the leading causes of death worldwide. Excessive nitric oxide production and inflammation result in dysfunctional vascular endothelial cells, which are critically involved in the initiation and progression of atherosclerosis. The present study aimed to identify a bioactive compound from Jerusalem artichoke leaves with anti-inflammatory activity that might prevent atherosclerosis. We isolated bioactive heliangin that inhibited NO production in LPS-induced macrophage-like RAW 264.7 cells. Heliangin suppressed ICAM-1, VCAM-1, E-selectin, and MCP-1 expression, as well as NF-κB and IκBα phosphorylation, in vascular endothelial cells stimulated with TNF-α. These results suggested that heliangin suppresses inflammation by inhibiting excessive NO production in macrophages and the expression of the factors leading to the development of atherosclerosis via the NF-κB signaling pathway in vascular endothelial cells. Therefore, heliangin in Jerusalem artichoke leaves could function in the prevention of atherosclerosis that is associated with heart attacks and strokes.

Behavioral Approaches with Firefighters: Introduction to the Special Issue

The past decade has witnessed burgeoning interest and concern regarding the mental health of firefighters. This increased attention is due, in part, to research documenting higher rates of psychiatric problems, including depression, substance abuse, sleep disturbances, posttraumatic stress disorder, and suicidality in fire rescue personnel compared to civilians. Similarly, the National Institute for Occupation Safety and Health (2014) has identified disturbingly elevated rates of physical health difficulties in firefighters, most notably high blood pressure, coronary heart disease, death due heart attacks, as well as different forms of cancer. Despite the heightened awareness of the mental and physical health challenges in this population, behavioral research specifically targeting firefighters is limited. With this is mind, we asked prominent researchers and clinicians working in this area to present results of their early investigative efforts in our Special Issue on “Behavioral Approaches with Firefighters”. In this Introduction, we provide brief summaries of the studies comprising the Issue. Articles in this issue address topics of sleep, PTSD, substance use, physical health concerns, and provide assessment and treatment considerations. A primary goal of the Issue is to stimulate further behavioral research with this group of deserving yet underserved first responders. Moreover, the Issue serves as a tribute to the men and women of the fire service who dedicate and risk their lives to serve their community.

PENGETAHUAN PERAWAT TENTANG HIGH-QUALITY CARDIOPULMONARY RESUSCITATION (CPR) DI ENAM RUMAH SAKIT SWASTA DI INDONESIA [NURSES' KNOWLEDGE ABOUT HIGH-QUALITY CARDIOPULMONARY RESUSCITATION (CPR) IN SIX PRIVATE HOSPITALS IN INDONESIA]

<p><em>Cardiac arrest is a significant cause of death worldwide, and an estimated 17.9 million people die from heart disease. In 2016, cardiac arrest represented 31% of all global deaths, and heart attacks and strokes caused 85%. In the treatment of cardiac arrest, health providers must perform cardiac and pulmonary resuscitation, a combination of chest compressions, and assistance for the victim's breathing. Nurses must be able to provide high-quality CPR to the patients for optimal outcomes. This study aimed to describe the knowledge of nurses in six private hospitals in Indonesia about high-quality CPR. This research was quantitative descriptive using a modified questionnaire regarding the theory of high-quality CPR. The population in this study were nurses from adult inpatient wards at six private hospitals in Indonesia with a total sample of 86 respondents through convenience sampling technique. The results showed that 79.1% inpatient nurses at six hospitals in Indonesia had good knowledge about high-quality CPR. Nurses are expected to maintain and improve their knowledge and ability to provide high-quality CPR so that the basic life support provided will be of high quality and provide optimal results for cardiac arrest patients in hospitals.</em><strong><br /><br />BAHASA INDONESIA ABSTRAK: </strong>Henti jantung merupakan penyebab kematian yang signifikan di dunia dan diperkirakan 17,9 juta orang meninggal karena penyakit jantung. Pada 2016, henti jantung mewakili 31% dari semua kematian global, dan 85% disebabkan oleh serangan jantung dan stroke. Dalam penanganan henti jantung, perawat harus melakukan resusitasi jantung dan paru yaitu kombinasi dari kompresi dada dan bantuan terhadap pernafasan korban. Tenaga kesehatan harus mampu memberikan<em> high-quality</em> CPR kepada korban untuk hasil yang optimal. Penelitian ini bertujuan untuk mengetahui gambaran pengetahuan perawat tentang high-quality CPR di enam rumah sakit swasta di Indonesia. Penelitian ini merupakan studi deskriptif kuantitatif dengan menggunakan kuesioner mengenai teori <em>high-quality</em> CPR yang telah dimodifikasi. Populasi dalam penelitian ini adalah perawat ruang rawat inap dewasa di enam rumah sakit swasta di Indonesia dengan jumlah sampel sebanyak 86 responden melalui teknik sampel konvenien. Hasil penelitian menunjukan 79.1% perawat rawat inap di enam rumah sakit di Indonesia memiliki pengetahuan tentang <em>high-quality</em> CPR pada tingkat yang baik. Perawat diharapkan untuk tetap mempertahankan dan meningkatkan pengetahuan dan kemampuan pemberian <em>high-quality CPR</em> sehingga bantuan hidup dasar yang diberikan akan berkualitas dan memberikan hasil optimal bagi pasien henti jantung dalam rumah sakit.</p>

ACTIVITY NANOKIRINYUH (CHROMOLAENA ODORATA) LEAVES EXTRACT IN ALLOXAN INDUCED DIABETIC RATS

Objective: Diabetes Mellitus is a type of degenerative disease that is increasing every year in countries around the world. Diabetes Mellitus is a major cause of blindness, kidney failure, heart attacks, and stroke. Nanokirinyuh leaves have potential as an antidiabetic because they contains chemical compounds that have antioxidant activity. The purpose of this study was to determine activity of nanokirinyuh leaves as an antidiabetic. Methods: Wistar rats as many as 24 animals were divided into 6 groups, namely the normal control group, positive control (glibenclamide 0.5 mg/Kg BW), negative control (alloxan 600 mg/BW rat), and nanochitosan kirinyuh leaves at a dose of 225 mg/Kg BW rat, 450 mg/Kg BW rat and 675 mg/Kg BW treatment was carried out for 10 d. Percent decrease of level glucose was evaluated along with histopathological investigation in various experimental groups of rats. Data analysis using the One Way Anova test and continued LSD test. Results: Level of Glucose at a dose of 675 mg/Kg BW rats showed the highest levels of the negative group and other dose groups. Pancreas histopathology test results showed that the group with a dose of 450 mg/Kg BW of rats had the lowest necrosis rate compared to the negative control group and other dose groups. Conclusion: Nanokirinyuh leaves can reduce of level plasma glucose and necrosis in a histopathology test.

Identify and Assess Drug Interactions with Atorvastatin in Inpatient Care

Background: Atorvastatin is a recent HMG-COA reductase inhibitor used to treat primary hypercholesterolemia, homozygous familial hypercholesterolemia, and mixed dyslipidemias. It is also taken to prevent heart disease, including strokes and heart attacks. In addition, Atorvastatin is used to lower bad cholesterol low-density lipoproteins (LDL) levels, increase good cholesterol high-density lipoprotein (HDL) levels, and lower triglycerides. It works by reducing the amount of cholesterol produced in the body, hence reducing the amount of cholesterol that may build up on the walls of arteries. Atorvastatin is long-acting, has few adverse effects, and is low in price. Nevertheless, it interacts with a wide variety of medications. These interactions may be lead to adverse drug reactions. Objective: The study aims to identify and asset atorvastatin interactions with other medicines at King Abdulaziz Hospital. Also, to prevent atorvastatin interactions in the future. Methods: The retrospective study investigated 280 electronic prescriptions inside the inpatient clinic at King Abdulaziz Hospital in Saudi Arabia between January and April 2021 to identify and asset interactions among atorvastatin and different medications. Results: Most atorvastatin interactions are category C (44.64%) and category B (41.43%). Atorvastatin had the most common interactions with esomeprazole (16.07%), clopidogrel (14.64%), and sitagliptin (12.14%). Atorvastatin had clinical interactions with medications metabolized by the cytochrome P450 3A4 )CYP3A4(. Use of atorvastatin with cyclosporine or clarithromycin increased the risk for atorvastatin toxicities such as myopathy and rhabdomyolysis. In addition, Atorvastatin decreases clopidogrel's antiplatelet effect and increases the risk of skeletal muscle toxicity of daptomycin. Conclusion: The majority of atorvastatin interactions may be avoided by adhering to best practices in clinical care and clinical pharmacology, such as avoiding complicated treatment regimens, utilizing a single pharmacy for all prescriptions, and recognizing patient risk factors. Health care professionals should use drug-drug interaction checkers such as Medscape and Micromedex, as well as a book such as the Handbook of Drug Interactions.

Molecular Imaging of Vulnerable Coronary Plaque with Radiolabeled Somatostatin Receptors (SSTR)

Atherosclerosis is responsible for the majority of heart attacks and is characterized by several modifications of the arterial wall including an inflammatory reaction. The silent course of atherosclerosis has made it necessary to develop predictors of disease complications before symptomatic lesions occur. Vulnerable to rupture atherosclerotic plaques are the target for molecular imaging. To this aim, different radiopharmaceuticals for PET/CT have emerged for the identification of high-risk plaques, with high specificity for the identification of the cellular components and pathophysiological status of plaques. By targeting specific receptors on activated macrophages in high-risk plaques, radiolabelled somatostatin analogues such as 68Ga-DOTA-TOC, TATE,0 or NOC have shown high relevance to detect vulnerable, atherosclerotic plaques. This PET radiopharmaceutical has been tested in several pre-clinical and clinical studies, as reviewed here, showing an important correlation with other risk factors.

Oxidative Stress and Cocaine Intoxication as Start Points in the Pathology of Cocaine-Induced Cardiotoxicity

Psychomotor stimulants are the most commonly used prohibited substances after cannabis. Globally, their use reaches epidemiological proportions and is one of the most common causes of death in many countries. The use of illicit drugs has negative effects on the cardiovascular system and is one of the causes of serious cardiovascular pathologies, ranging from abnormal heart rhythms to heart attacks and sudden cardiac death. The reactive oxygen species generation, toxic metabolites formation, and oxidative stress play a significant role in cocaine-induced cardiotoxicity. The aim of the present review is to assess acute and chronic cocaine toxicity by focusing on the published literature regarding oxidative stress levels. Hypothetically, this study can serve as a basis for developing a rapid and effective method for determining oxidative stress levels by monitoring changes in the redox status of patients with cocaine intoxication.