Depresija, anksioznost i stres kod zdravstvenih djelatnika u vrijeme pandemije COVID-19

Introduction: The pandemic of the disease COVID-19 has a tremendous emotional impact on both patients and health workers who are in charge of assisting the infected. The heavy burden on them is further increased by the high and constant risk of exposure to infection and death and separation from their families. The newly created excessive professional demands that the environment around us sets, which cannot be adequately responded to, are the drivers, or stressors, that form the basis for depression and anxiety. Methods: A questionnaire survey (DASS-21) was conducted on 100 employees of the Croatian Hospital “Dr. fra Mato Nikolić” Nova Bila in the period from June to October 2022. The respondents were doctors and nurses who work in intensive care units, the internal department, and the surgery department. Results: All respondents had a certain level of stress (40% extremely severe stress), anxiety (65% extremely severe anxiety), and depression (46% extremely severe depression). There is a significant correlation between stress, depression, and anxiety with concern for the financial situation considering the consequences and impact of the COVID-19 pandemic. There is also a correlation with the claim of concern for one\u27s own mental health, but also with the fear of infection or reinfection with the virus. Conclusion: Healthcare workers who work with patients with COVID-19 are significantly exposed to stress, anxiety, and depression. It is necessary to provide healthcare workers with psychophysical support, especially in crises such as the pandemic caused by COVID-19.Uvod: Pandemija bolesti COVID-19 ima veliki emocionalni utjecaj kako na pacijente, tako i na zdravstvene djelatnike koji su zaduženi za pružanje pomoći zaraženima. Veliko opterećenje zdravstvenih djelatnika dodatno je povećano visokim i postojanim rizikom od izloženosti zarazi i smrti te odvajanjem od svojih obitelji. Novonastali prekomjerni profesionalni zahtjevi koje okruženje oko nas postavlja, a na koje se ne može primjereno odgovoriti, predstavljaju pokretače, odnosno stresore koji stvaraju podlogu za depresiju i anksioznost. Metode: Istraživanje anketnim upitnikom provedeno je na 100 ispitanika, odnosno zaposlenika Hrvatske bolnice “Dr. fra Mato Nikolić” Nova Bila u periodu od lipnja do listopada 2022. godine. Ispitanici su bili liječnici i medicinske sestre koji rade u jedinicama intenzivne skrbi, internog odjela i odjela kirurgije. Rezultati: Svi ispitanici imali su prisutnu određenu razinu stresa (40 % njih imalo je visoku razinu stresa), anksioznosti (65 % ispitanika imalo je visoku razinu anksioznosti) i depresije (46 % njih imalo je visoku razinu depresije). Značajna je povezanost stresa, depresije i anksioznosti sa zabrinutošću za financijsku situaciju s obzirom na posljedice i utjecaj pandemije COVID-19, te je značajna korelacija s tvrdnjom o zabrinutošću za vlastito mentalno zdravlje, ali i strahom od zaraze ili ponovne zaraze virusom. Zaključak: Zdravstveni djelatnici koji rade s oboljelima od bolesti COVID-19 značajno su izloženi stresu, anksioznosti i depresiji. Neophodno je zdravstvenim djelatnicima osigurati psihofizičku potporu, osobito u kriznim situacijama poput pandemije uzrokovane bolešću COVID-19

EARLY DETECTION OF ACUTE KIDNEY INJURY IN PRETERM NEWBORNS WITH PERINATAL ASPHYXIA USING SERUM CYSTATIN

Introduction:The diagnosis of acute kidney injury (AKI) in preterm newborns with perinatal asphyxia based on increased serum creatinine (sCr) value and oliguria/anuria is usually delayed. The Aim of this paper is to evaluate serum cystatin C as an early predictor of AKI. Materials and methods:The study included 42 preterm newborns (24-37 weeks) with perinatal asphyxia (Apgar score (AS) ≤ 3 at 5 minutes of life or blood pH on admission ≤ 7.00). The sCr and sCys-C levels were measured on the 1st, 3rd, and 7th day of life. According to KDIGO criteria, the newborns were classified into groups, and sCr and sCys-C values were compared. Results:The mean gestational age was 29.9 ± 3.0 weeks. AKI was diagnosed in 62.8 % of patients. Of these patients, 81.5% belonged to AKI 1 group, and 18.5 % to AKI 2 group.No newborns had the criteria for AKI 3. On day 7 the mean sCr values were significantly higher in AKI (65.4± 21.8) compared with the non-AKI group (168.4±38.2) (p<0.001), but not on day 1 and 3 (p = 0.322, 0.012, respectively). The sCys-C values were significantly higher in the AKI group on day 3 ( AKI vs. non-AKI group, 0.69 ±0.22 vs. 1.22 ±0.20; p <0.001) and day 7 (AKI vs. non-AKI group, 0.62 ±0.41 vs. 1.68 ±0.20; p <0.001). The sCys-C was also an earlier marker of a more severe stage of AKI than sCr. Conclusion:The sCys-C was elevated earlier than sCr, making it a valuable diagnostic tool for AKI in preterm newborns