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.

Restorative juvenile justice

Problem setting.Today, society is developing rapidly, there is a process of globalization, the influence of information technology is growing significantly, which in some way complicates public relations and conflicts that need to be effectively resolved and resolved through justice. Raising this issue, in our opinion, we should first of all pay attention to such a problem as juvenile delinquency, because it is the rapid development of information technology has significantly affected the spread of this phenomenon. Thus, it should be emphasized that the state does not fully contribute to solving this problem, which just clearly illustrates the problem in the introduction of juvenile justice in Ukraine. The actualization of this issue is primarily due to the lack of understanding of the implementation of new changes in the protection of children’s rights in Ukraine. The state must understand that it has a responsibility to increase the responsibility of adults for the safety and lives of people. In turn, as already mentioned, low social protection of children creates crime among minors. And here there is another problem: the application of official justice, which involves primarily the application by the state to offenders of certain coercive measures, which is provided for in the sanctions of legal norms. In our opinion, this method of justice does not help to resolve the conflict between the victim and the accused. Because, in criminal proceedings, the main mediator of the accusation is the state, as a result of which the injured party receives double damage: both from the criminal offense itself and directly from justice, which has not solved the real problem in essence. In turn, the offender, through the application of appropriate means of state coercion, is not aware of his responsibility for the act committed by him. Thus, today there is a need for the introduction and application of restorative justice in juvenile cases. Since the restorative approach is aimed at restoring the socio-psychological condition of both participants in the process, as well as real compensation for the damage to the injured party. Target of research. Investigate juvenile justice in Ukraine, and the commission of criminal offenses by minors. Correlate the concepts of formal and restorative justice, as well as consider the need for restorative justice in Ukraine. Investigate national and international practices of juvenile justice, and implemented alternative programs for the application of restorative justice practices against juveniles in Ukraine. The object of this study is: juvenile justice, the commission of criminal offenses by minors, restorative justice in Ukraine, as well as the involvement of international practices in the application of restorative justice to minors. Analysis of reсent researches and publications. This issue was studied by the following scientists: G. Kostova, V. Zemlyanska, V. Lyska, V. Sidletska and others. Article’s main body. The article is devoted to the problem of introduction of restorative justice in juvenile cases in Ukraine. The authors studied the functioning of juvenile justice in Ukraine, as well as the implementation of state programs for the introduction of restorative practices, by reviewing the main provisions of national law and international practices. The author’s position and proposals for further reform of criminal justice for juveniles in Ukraine are formulated by introducing a restorative approach involving international practices. Norway is considered to be the first country to establish rehabilitation practices for minors. It is this leading country that has been based on the origins of mediation since 1970, but began on the basis of an experiment in the theft committed by a minor who was known in 1981. The case was a success, and in recent years almost 81 of Norway’s 345 municipalities have supported innovation – restorative justice, which has been expressed in a community decision in their area. And since 1991 it has become more accessible in 1991. Norwegian law enshrines this provision in the Municipal Mediation Councils Act, which was established in 1991, the 1992 Resolutions, the 1993 Circular, sections 71-72 of the 1998 Code of Criminal Procedure, and Part 2 include the right to the prosecutor in case of committing a non-public dangerous act without illegal consequences to transfer the offender to the mediation process. Conclusions and prospects for the development. Currently, the state and trends of juvenile delinquency, as shown by the analysis of judicial statistics, indicate the urgent need to organize consolidated and targeted actions of society and the state to prevent such crime, prevent its development and growth. Canada and Norway, we have established that they carry out executive activities for the restoration of justice, communication and restoration of justice, protection of fundamental human rights and freedoms, public relations. Also, these states are passing laws to get closer to the basics of restorative justice. Despite their imperfections, their direct component is the formation of the moral condition of both parties, ensuring their understanding of the crime, solving issues related to the moral condition of the victim, which is manifested in her conscious assessment of the situation, psychological rehabilitation in case of mental illness: panic attacks. , depression, which require quality treatment. Also, it is fundamental to report the guilt of a juvenile offender for his crime, the implementation of alternative measures of punishment: community service, a fine that would positively affect the further behavior of the offender. As practice shows, such an alternative in Ukraine would be a good attempt to minimize the level of crime among criminals also through advocacy in the form of lectures, seminars on offenses, as well as the adoption of alternative regulations in Ukraine, which would legally support mediation.

A systematic review of person-centred adjustments to facilitate magnetic resonance imaging for autistic patients without the use of sedation or anaesthesia

Magnetic resonance imaging is widely used for different diagnostic examinations involving autistic patients. The noisy, narrow, isolating magnetic resonance imaging environment and long scan times may not be suitable for autistic individuals, given their communication challenges, sensory sensitivities and often heightened anxiety. This systematic review aims to reveal any reasonable and feasible radiography-based adjustments to facilitate magnetic resonance imaging scanning without the use of sedation or general anaesthesia. Nine electronic databases were systematically searched. Out of 4442 articles screened, 53 were deemed directly relevant; when assessed against eligibility criteria, only 21 were finally included in this systematic review. Customising communication was found to be a key adjustment, as well as scan-based optimisation and environmental adaptations. The importance of distraction techniques and use of technology for familiarisation with the processes was also highlighted. The results of this study can inform recommendations to improve magnetic resonance imaging practice and patient experience, without the use of sedation or anaesthesia, where feasible. They can also inform the basis of dedicated training for magnetic resonance imaging radiographers. Lay abstract Autistic patients often undergo magnetic resonance imaging examinations. Within this environment, it is usual to feel anxious and overwhelmed by noises, lights or other people. The narrow scanners, the loud noises and the long examination time can easily cause panic attacks. This review aims to identify any adaptations for autistic individuals to have a magnetic resonance imaging scan without sedation or anaesthesia. Out of 4442 articles screened, 53 more relevant were evaluated and 21 were finally included in this study. Customising communication, different techniques to improve the environment, using technology for familiarisation and distraction have been used in previous studies. The results of this study can be used to make suggestions on how to improve magnetic resonance imaging practice and the autistic patient experience. They can also be used to create training for the healthcare professionals using the magnetic resonance imaging scanners.

Directed motivational currents: A systematic review

Directed motivational currents, unique and intense goal-directed motivational surges lasting over a period of time, have received increasing attention recently. This article reports the first systematic review of this phenomenon. A total of 21 reports appearing between 2013 and 2020 were included in the analysis. The results show that the majority of empirical reports were small-scale qualitative studies (median = 18 participants). The evidence on the three characteristics proposed as necessary and/or distinguishing conditions of directed motivational currents (vision, salient facilitative structure, and positive affect) is inconclusive due to the presence of directed motivational currents cases not exhibiting these features, and the absence of direct comparative analyses with non-directed motivational currents cases. A few intervention studies (N = 4) were conducted, but their results are also inconclusive due to a number of methodological limitations. Contrary to the claim that directed motivational current experiences are the “optimal form” of motivation, the results additionally showed that these experiences could lead to intense stress, anxiety, depression, sleeplessness, and panic attacks, thereby raising ethical concerns about deliberately inducing directed motivational currents in learners. We conclude that, although the concept of directed motivational currents is promising, more research is needed to reach a better understanding of its potential. We end this article by suggesting directions for future research into directed motivational currents, including renaming them as sustained flow.

Psychosocial Impact of COVID-19: Health Impact and Clinical Findings

Besides its high mortality rates, COVID-19 disease has dramatic psychosocial and psychological effects worldwide. There are significant reports of mental issues, panic attacks, anxiety, depression, and financial difficulties, and the effects continue to persist months after recovery [1]. The disease itself multipliedgic by many other problems like post-traumatic stress disorder, depression, change in behaviors. All these have a significant impact on their lives [1]. It also has adverse effects on pregnancy. COVID-19 has affected the mother as well as the child’s health. There are many panic and anxiety issues. Many deaths were not even reported. Coronavirus pandemic has led to many health and mental illnesses. Many lockdowns led to financial difficulties and problems in the present and future. Long-term neuropsychiatric effects may be caused by more than only the massive psychological trauma suffered during the outbreak. Poor developmental outcomes in offspring have been associated with prenatal psychological distress, including abnormalities in brain development 4, 7, and worse socio-emotional and cognitive development. This article tends to define the psychosocial (psychosocial remove) impact of COVID-19 on students, health workers, pregnant women, how their lives and mental health are affected worldwide. COVID-19 affected the workplace. Stress throughout pregnancy and early life has been linked to cancer lately. It has affected many lives in agricultural areas, economic-financial losses. Current reports put forward feasible passing on vertical coronavirus, although longitudinal studies offspring are needed. The paternal infection on the offspring and generational upshot can be contemplated.

Screening and Psycho-Oncological Support for Patients With Head and Neck Cancer and Brain Malignancies Before Radiotherapy With Mask Fixation: Results of a Feasibility Study

This single-center, single-arm trial investigates the feasibility of a psycho-oncological care program, which aims to reduce psychological distress and improve compliance with radiotherapy with mask fixation in patients with head and neck cancer or brain malignancies. The care program comprised (1) a screening/needs assessment and (2) the provision of a psycho-oncological intervention using imaginative stabilization techniques for distressed patients (distress due to anxiety ≥5) or in a case of subjective interest in the psycho-oncological intervention. Another allocation path to the intervention was directly through the radiation oncologist in charge who classified the patient as: in need of support to tolerate the immobilization device. Of a total of 1,020 screened patients, 257 (25.2%) patients indicated a distress ≥5 and 141 (13.8%) patients reported panic attacks. 25% of the patients reported a subjective interest in psycho-oncological support. A total of 35 patients received the psycho-oncological intervention, of which 74% were assigned by radiation oncologists. In this small patient cohort, no significant pre-post effects in terms of depression, anxiety, distress, and quality of life (mental and physical component scores) could be detected. Our results indicate a good feasibility (interdisciplinary workflow and cooperation, allocation by physicians in charge) of the psycho-oncological care program for this cohort of patients before radiotherapy with mask fixation. The screening results underline the high psychological distress and demand for psycho-oncological support. However, since the utilization of our intervention was low, future studies should reduce the barriers and improve compliance to psycho-oncological services by these patients.Clinical Trial Registration: https://www.drks.de/drks_web/setLocale_EN.do #DRKS00013493

FEATURES OF THERAPY FOR PANIC DISORDER, ASSOCIATED WITH THE SARS-COV-2 PANDEMIC

Введение. В силу существенной схожести симптомов острого респираторного синдрома SARS-CoV-2 и панического расстройства (ПР), диагностика представляет значительные трудности. ПР имеют тенденцию развиваться хронически, с рецидивами на протяжении всей жизни. Цель работы: выявить особенности клинического проявления ПА/ПР на фоне COVID-19 и обосновать оптимальную схему терапии. Методы. Проведен анализ данных 86 пациентов, у которых диагностировано ПР при обращении на консультативный неврологический прием КФ UMC с мая 2020 г по май 2021 г. Скрининг панического расстройства проведен по Шкале тревоги Шихана (Sheehan Anxiety Rating Scale, ShARS). Результаты. Среди пациентов было 54 (62,8%) женщины и 32(37,2%) мужчины. По шкале ShARS тяжелым тревожное расстройство (80 баллов и выше) определено у 39 (45,3%), у остальных тревога (от 30 до 80 баллов) - клинически выраженная. Диагноз ПР у 21(24,4%) был диагностирован ранее заражения ковидной инфекцией. У остальных, выставлен впервые 26 (30,2%) пациентам, ранее не обращавшихся к неврологу и 39 (45,3%) пациентам, обращавшихся к неврологу с диагнозами соматоформная вегетативная дисфункция, сосудистая цефалгия, мигрень, обсессивно-компульсивное расстройство. Бронхиальная астма отмечалась в анамнезе в 13 (15,1%) случаях. Разновидности панических приступов были расценены как большие (развернутые) ПР (4 симптома и более) - у 55 (64%), в остальных случаях как симптоматически бедные. Особенность течения ПР на фоне SARS-CoV-2 определяется возникновением на фоне ипохондрических фобий. В то же время агорафобии и избегающего поведения, характерных для ПР, не отмечалось. Заключение. Использование бензодиазепинов для анксиолитических целей, противоастматических препаратов может быть контрпродуктивным в лечении тревожных расстройств. Ятрогенный риск наслаивается на возможную гипокалиемию, удлинение интервала QTc, артериальную гипертензию, вызванную COVID-19. Оценка результатов проведённого нейрофармакологического анализа и назначения препаратов анксиолитического действия Бифрен, в более тяжелых случаях ПР Прегабина показала клинический положительный эффект. Introduction. Due to the significant similarity between the symptoms of SARS-CoV-2 acute respiratory syndrome and panic disorder (PD), diagnosis presents significant difficulties. PD tend to develop chronically, with lifelong relapses. Purpose of the work: to identify the features of the clinical manifestation of PD in the presence of COVID-19 and to substantiate the optimal therapy regimen. Methods. We analyzed the data of 86 patients who were diagnosed with PD when they applied for a consultative neurological appointment CF UMC from May 2020 to May 2021. Panic disorder was screened according to the Sheehan Anxiety Rating Scale (ShARS). Results. Among the patients there were 54 (62.8%) women and 32 (37.2%) men. On the ShARS scale, severe anxiety disorder (80 points and higher) was identified in 39 (45.3%), in the rest anxiety (from 30 to 80 points) was clinically expressed. The diagnosis of PD in 21 (24.4%) was diagnosed earlier than contracting a covid infection. The rest were exposed for the first time to 26 (30.2%) patients who had not previously visited a neurologist and 39 (45.3%) patients who visited a neurologist with diagnoses of somatoform autonomic dysfunction, vascular cephalgia, migraine, obsessive-compulsive disorder. A history of bronchial asthma was observed in 13 (15.1%) cases. The types of panic attacks were regarded as large (extensive) PR (4 symptoms or more) - in 55 (64%), in other cases as symptomatically poor. The peculiarity of the course of PR against the background of SARS-CoV-2 is determined by the occurrence of hypochondriac phobias against the background. At the same time, agoraphobia and avoidant behavior characteristic of PD were not observed. Conclusion. The use of benzodiazepines for anxiolytic purposes, anti-asthma drugs may be counterproductive in the treatment of anxiety disorders. The iatrogenic risk is superimposed on possible hypokalemia, prolongation of the QTc interval, arterial hypertension caused by COVID-19. Evaluation of the results of the neuropharmacological analysis and the appointment of drugs with anxiolytic action Bifren, in more severe cases of Pregabin in PR showed a clinical positive effect.

The Effect Of Pre-Phacoemulsification Education On Cataract Patients’ Anxieties In Rumah Sakit Islam Banjarmasin

Pasien yang akan mengalami tindakan Phacoemulsifikasisering mengalami kecemasan karena kurangnya informasi yang diberikan. Pemberian infromasi ini diperoleh dari edukasi yang dilakukan oleh perawat sebelum tindakan phacoemulsifikasidilakukan. Penelitian ini bertujuan untuk mengetahui pengaruh edukasi pre-phacoemulsifikasiterhadap kecemasan pasien katarak di Rumah Sakit Islam Banjarmasin. Penelitian ini menggunakan desain pre-eksperimen dengan menggunakan rancangan one group pretest posttest design. Populasi adalah semua pasien pre-operasi phacoemulsifikasidi Poliklinik Mata pada tanggal 21 November sampai dengan 21 Desember 2020 dengan tekhnik accidental sampling berjumlah 20 orang. Analisis data menggunakan wilcoxon signed rank test. Hasil Penelitian menunjukkan penurunan kecemasan dari kecemasan sedang menjadi kecemasan ringan sebelum ke sesudah diberikan edukasi dengan nilai ρ = 0,000. Penelitian ini menyarankan agar perawat sebaiknya melakukan edukasi pre-phacoemulsifikasikepada pasien katarak menggunakan SOP yang telah dientukan oleh rumah sakit. Kata Kunci: Edukasi,Katarak, Kecemasan Daftar Rujukan Anggreny, L.O (2018) Hubungan Sumber Akses Informasi Terhadap Tingkat Kecemasan Pada Klien Pre Operasi Katarak di Rumah Sakit Mata Smec Balikpapan. Jurnal Nerspedia. Volume 2. Nomor 1. Edisi April 2019 Bruce, J (2015). Lecture Notes Oftalmologi. Alih bahasa: dr. Asri Dwi Rachmawati. Jakarta: Erlangga Evans, D. C (2013). Alleviating Anxiety and Preventing Panic Attacks in the Surgical Patient.” AORN Journal Volume 97. Nomor 3. Edisi 2013 Hawari, D (2015). Manajemen Stres Cemas Dan Depresi Hypnosis. Jakarta: Fakultas Kedokteran Universitas Indonesia. Mansjoer, A. (2014). Kapita Selekta Kedokteran. Edisi 4. Jakarta: Media Aesculapius McEwen & Wills, (2011). Dasar Teori Keperawatan. Jakarta: EGC Ping, G (2012). A Preoperative Education Intervention to Reduce Anxiety and Improve Recovery Among Chinese Cardiac Patients: A Randomised Controlled Trial. Thesis, University of Nottingham Pirhonen, Silvennoinen, and Sillence, (2014). Patient Education as an Information System, Healthcare Tool and Interaction. Information System Education Journal, Volume 25 Nomor 4. Edisi 2014 Potter & Perry, (2014). Buku Ajar Fundamental Keperawatan: Konsep, Proses, dan Prektik. Edisi 4. Volume 2. Alih Bahasa: Renata Komalasari, dkk. Jakarta: EGC Riskesdas (2013). Laporan Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan RI. Riskesdas (2018). Laporan Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementrian Kesehatan RI. Smeltzer, S. (2012). Keperawatan Medikal Bedah. Jakarta: EGC Stuart, G, W (2012). Buku Saku Keperawatan Jiwa. Edisi 5. Jakarta: Buku Kedokteran EGC. Tauqir, (2012) Knowledge of patients’ visual experience during cataract surgery: a survey of eye doctors in Karachi, Pakistan. BMC Ophthalmology. Volume 12. Nomor 55. Edisi 2012 Wahyuningtyas, S. P. (2016). “Hubungan Tingkat Pengetahuan Tindakan Phacoemulsifikasi Dengan Kecemasan Pada Pasien Katarak Di Rumah Sakit Mata Solo‟. skripsi thesis, Universitas Muhammadiyah Surakarta World Health Organization, (2018). Prevention of Blindness Program, Infodatin Pusat Data dan Informasi Kementerian Kesehatan RI, 1-7. Hyperlink "http://www.depkes.go.id/download.php?file=download/pusdatin/infodatin/infodatin-hipertensi.pdf. Diakses pada tanggal 01 April 2021.