Dysfunctional psychological responses among Intensive Care Unit nurses: a systematic review of the literature.

OBJECTIVE: To systematically review evidence on dysfunctional psychological responses of Intensive Care Units nurses (ICUNs), with focus on anxiety and depressive symptoms and related factors. METHOD: A literature search was performed in CINAHL, PubMed and Scopus databases, from 1999 to present, along with a critical appraisal and synthesis of all relevant data. The following key words, separately and in combination, were used: "mental status" "depressive symptoms" "anxiety" "ICU nurses" "PTSD" "burnout" "compassion fatigue" "psychological distress". RESULTS: Thirteen quantitative studies in English and Greek were included. The results suggested increased psychological burden in ICUNs compared to other nursing specialties, as well as to the general population. CONCLUSIONS: Studies investigating psychological responses of ICUNs are limited, internationally. Future longitudinal and intervention studies will contribute to a better understanding of the phenomenon.

Dysfunctional psychological responses among Intensive Care Unit nurses: a systematic review of the literature / Respostas psicológicas disfuncionais em enfermeiros de Unidades de Cuidados Intensivos: uma revisão sistemática da literatura / Respuestas psicológicas disfuncionales en enfermeros de Unidades de Cuidados Intensivos: una revisión sistemática de la literatura

AbstractOBJECTIVETo systematically review evidence on dysfunctional psychological responses of Intensive Care Units nurses (ICUNs), with focus on anxiety and depressive symptoms and related factors.METHODA literature search was performed in CINAHL, PubMed and Scopus databases, from 1999 to present, along with a critical appraisal and synthesis of all relevant data. The following key words, separately and in combination, were used: "mental status" "depressive symptoms" "anxiety" "ICU nurses" "PTSD" "burnout" "compassion fatigue" "psychological distress".RESULTSThirteen quantitative studies in English and Greek were included. The results suggested increased psychological burden in ICUNs compared to other nursing specialties, as well as to the general population.CONCLUSIONSStudies investigating psychological responses of ICUNs are limited, internationally. Future longitudinal and intervention studies will contribute to a better understanding of the phenomenon.

ResumoOBJETIVORever sistematicamente evidências de respostas psicológicas disfuncionais em Enfermeiros de Unidades de Cuidados Intensivos (EUCI), com foco na ansiedade, sintomas depressivos e fatores relacionados.MÉTODOFoi realizada uma pesquisa bibliográfica, com avaliação crítica e síntese de dados dos estudos, nas bases de dados da CINAHL, PubMed e Scopus, para o período de 1999 até ao presente. Foram utilizados os seguintes termos de pesquisa, individualmente ou em combinação: "estado mental" "sintomas depressivos" "ansiedade" "enfermeiros de UCI" "PTSD" "burnout" "fadiga da compaixão" "stress psicológico".RESULTADOForam incluídos treze estudos quantitativos em Inglês e Grego. Os resultados sugerem um aumento da carga psicológica nos EUCI comparativamente com outras especialidades de enfermagem, assim como com a população em geral.CONCLUSÕESEstudos internacionais de investigação sobre a resposta psicológica de EUCI são limitados. Estudos futuros, longitudinais e de intervenção, irão contribuir para uma melhor compreensão do fenômeno.

ResumenOBJETIVOBuscar evidencias de respuestas psicológicas disfuncionales en Enfermeros de Unidades de Terapia Intensiva, con enfoque en la ansiedad, síntomas depresivos y factores relacionados.MÉTODORevisión sistemática, con evaluación crítica y síntesis de datos de los estudios, llevada a cabo en las bases de datos CINAHL, PubMed y Scopus, en el período de 1999 hasta el presente, utilizándose los siguientes términos de investigación, individualmente o en combinación: "estado mental", "síntomas depresivos", "ansiedad", "enfermeros de UCI", "estrés post traumático", "burnout", "fatiga por compasión" y "estrés psicológico".RESULTADOFueron incluidos trece estudios cuantitativos en Inglés y Griego. Los resultados sugieren un incremento de la carga psicológica en los Enfermeros de UCI comparativamente con otras especialidades de enfermería, así como con la población en general.CONCLUSIÓNEstudios internacionales de investigación acerca de la respuesta psicológica son limitados. Estudios futuros, longitudinales y de intervención, contribuirán a una mejor comprensión del fenómeno.

Acute anterior myocardial infarction after multiple bee stings. A case of Kounis syndrome.

A 58-year-old man with no history of cardiac diseases or cardiovascular risk factors was stung by honeybees. Soon after, he gradually developed signs of an allergic reaction followed by severe retrosternal pain. Electrocardiographic, echocardiographic evidence and positive biochemical markers were consistent with an acute anterolateral myocardial infarction. Coronary arteriography showed a left anterior descending artery thrombotic lesion. This is a case of Kounis syndrome, which is the concurrence of acute coronary syndromes with conditions associated with mast cell activation including allergic or hypersensitivity reactions as well as anaphylactic or anaphylactoid insults. The clinical implications and pathophysiology of this dangerous association are discussed.

Does the presence of anti-CCP autoantibodies and their serum levels influence the severity and activity in rheumatoid arthritis patients?

This study aims to investigate the association of the presence and of the titer of autoantibodies against cyclic citrullinated peptides (aCCP), with clinical manifestations and disease activity in a cohort of patients with rheumatoid arthritis (RA). From January 2000 through December 2005, 135 patients were diagnosed with RA at the Rheumatology Unit of our hospital. Demographic, clinical, laboratory, and therapeutic parameters were evaluated in all patients at study entry and at every follow-up visit. Positivity in aCCP and also their levels were determined for all patients. At the end of the study, we reevaluated the above parameters, dividing patients into aCCP positive and aCCP negative. From 135 patients, 53.3% were aCCP positive. The majority of aCCP-positive patients were males (p<0.001), positive to rheumatoid factor (p<0.001) and current smokers (p<0.05). At diagnosis, aCCP-positive patients presented with higher tender joint counts (p<0.001) and swollen joint counts (p<0.001), and exhibited more active disease, expressed by higher disease activity scores for 28 joints (DAS-28) (p<0.001). At the end of the study, aCCP-positive patients also displayed more active disease, with higher DAS-28 (p<0.001), and more severe disease, as this was indicated by the higher radiological Larsen score (p<0.001). The serum levels of aCCP were not found to be associated with disease activity and severity. In early RA, the presence of aCCP is associated with increased disease activity and severity. This was found to be independent of circulating levels of aCCP.