Posible especificidad de los síntomas tipo pánico inducidos por inhalantes: a propósito de un caso

La intoxicación aguda por inhalantes produce distintos síntomas psiquiátricos y se ha documentado daño orgánico cerebral por exposición crónica a los mismos. Describimos la aparición de un subgrupo específico de síntomas tipo pánico, tras la exposición a solventes volátiles, en una mujer de 36 años con historia de exposición profesional y adicción a los solventes volátiles que posteriormente desarrolló un trastorno de pánico comórbido con escasa respuesta al tratamiento antidepresivo. La paciente se evaluó mediante la administración del SCL-90-R, el WAIS y el test de Rorschach; también se le realizó RM de medio contraste. No se encontraron datos sólidos de daño cerebral, aunque sus síntomas de ansiedad cumplen criterios para el subtipo neurobiológico de trastorno de pánico no relacionado con miedo a asfixia. Este subgrupo de síntomas de ansiedad se atribuye al mecanismo de acción de los solventes volátiles, es decir, la neurotransmisión gabaérgica

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Impulsiveness neurobiological substrate in borderline personality disorder

Tendency to answer to frustrations with "acting out" in Borderline personality disorder suggests a difficult symbolising process. Neurobiological studies evidence a malfunctioning of frontal, prefrontal and limbic areas probably neurobiological substrate of impulsiveness. After complete psychological screening and SCIDII interview, by a video emotional activation paradigm, standard-SPECT analysis recorded cerebral activity of 3 borderline personality disorder patients and of a control subject. In borderline patients, but not in control subject, limbic areas, frontal and prefrontal cortex activation was present perhaps to show a cognitive activity put in action in order to manage the strong emotion triggered by video

Posible especificidad de los síntomas tipo pánico inducidos por inhalantes: a propósito de un caso

La intoxicación aguda por inhalantes produce distintos síntomas psiquiátricos y se ha documentado daño orgánico cerebral por exposición crónica a los mismos. Describimos la aparición de un subgrupo específico de síntomas tipo pánico, tras la exposición a solventes volátiles, en una mujer de 36 años con historia de exposición profesional y adicción a los solventes volátiles que posteriormente desarrolló un trastorno de pánico comórbido con escasa respuesta al tratamiento antidepresivo. La paciente se evaluó mediante la administración del SCL-90-R, el WAIS y el test de Rorschach; también se le realizó RM de medio contraste. No se encontraron datos sólidos de daño cerebral, aunque sus síntomas de ansiedad cumplen criterios para el subtipo neurobiológico de trastorno de pánico no relacionado con miedo a asfixia. Este subgrupo de síntomas de ansiedad se atribuye al mecanismo de acción de los solventes volátiles, es decir, la neurotransmisión gabaérgica

Further evidence for low serum cholesterol and suicidal behaviour

OBJECTIVE: To examine for a relationship between serum cholesterol and suicidal behavior. METHODS: Patients admitted after an overdose (N=120) were compared with controls (N=120) for their serum cholesterol levels. RESULTS: Patients who had overdosed had significantly lower serum cholesterol levels than controls (mean+/-S.D. 171+/-31 vs. 196+/-30 mg/dl, P<0.0001). CONCLUSION: These results add to a grouping literature reporting that low serum cholesterol is associated with suicidal behavior