ANXIETY AND DEPRESSION IN PAEDIATRIC PATIENTS WITH PAINFUL SOMATIC COMPLAINTS

Cilj istraživanja je bio procijeniti razinu i strukturu anksioznosti i depresivnosti djece i mladih s ponavljanim bolnim tjelesnim tegobama (1) i usporediti ih s vrijednostima normativnog uzorka (2), usporediti bolesnike s pojedinačnim i one s višestrukim tjelesnim tegobama te (3) ispitati proporciju klinički značajno anksioznih i depresivnih bolesnika. Skalom strahova i anksioznosti (SKAD-62) i skalom depresivnosti (SDD) ispitano je 160-ero djece u dobi od 10 do 17 godina, koju su pedijatri uputili psihologu u okviru bolničkog ili ambulantnog liječenja: 57-ero djece s glavoboljama, 24-ero s bolovima u trbuhu, 40-ero s bolovima u prsištu i njih 39-ero s višestrukim tegobama. Rezultati su pokazali kako svi bolesnici imaju sličnu ukupnu razinu anksioznosti i depresivnosti kao i djeca iz normativnog uzorka. Klinički značajna anksioznost registrirana je u 22%, a klinički značajna depresivnost u 4% bolesnika. Najviše je visoko anksiozne djece s bolovima u prsištu (35%), a najmanje s glavoboljama (8,6%). Djeca s višestrukim tjelesnim tegobama ne iskazuju veću anksioznost i depresivnost od one s pojedinačnim tegobama. Između kliničkih skupina iskazana je razlika u dominantnim oblicima anksioznosti: djeca s glavoboljama većinom su separacijski anksiozna, ona s bolovima u trbuhu i u prsištu većinom su anksiozno osjetljiva, a djeca s više tjelesnih tegoba zabrinuta.The aim of this study was to examine the level and different aspects of anxiety and depression in children and youth with recurrent painful somatic complaints and (1) compare them to the norm values of a general population sample, (2) compare the patients with single complaints to patients with multiform somatic complaints and (3) to examine the proportion of clinically significant anxiety and depressive patients. The Fear and Anxiety Scale SKAD-62 and The Depression Scale SDD were applied to 160 children, ages 10 to 17, who were referred by paediatric specialists for psychology assessment under hospital or ambulatory treatment: 56 with headaches, 24 stomach pain sufferers, 40 chest pain sufferer and 39 children with multiple somatic complaints. The results showed that all patients had similar global levels of anxiety and depression as compared to the norm values. Clinically significant anxiety was observed in 22% patients and clinically significant depression in 4% patients. Most anxiety in patients was found in the chest pain group (35%) and less in those with headache (8.6%). Children with multiform complaints are as anxious as single complaint sufferers. A difference was found between clinical samples in different aspects of anxiety symptoms: those with headache were separation anxious, abdominal and chest pain sufferers were more anxiety sensitive, multiform complainers were more worried

Usporedba učinkovitosti lokalnog anestetika i kognitivnog postupka za suzbijanje boli kod djece

Numerous studies have shown the influence of psychological factors on pain sensation, as well as efficacy of cognitive methods in its prevention. The objective of this study was to examine whether there was a difference in efficacy of cognitive method in pain prevention (distraction) and pharmacological method (EMLA cream) during venepuncture in hospitalised children. It is well known that routine diagnostic procedures are significant sources of stress in such children. The pharmacological methods that are mostly applied in pain prevention are rather expensive, may cause adverse side-effects and may be rather complicated in their application (as it is the case with EMLA cream). The said study was carried out on 64 children (10 to 18 years) randomly assigned to two treatment groups. In one group, in which pain was prevented by applying the cognitive technique, there were 16 boys and 15 girls. The group in which pharmacological technique was applied consisted of 15 boys and 18 girls. The obtained results neither show any statistically significant difference in efficacy of a particular technique regarding gender, nor any statistically significant difference in efficacy generally. The fact that cognitive techniques are easier to apply, more economic and not known to cause any side-effects, justifies their application in pain prevention during venepuncture in hospitalised children.Brojna istraživanja su pokazala utjecaj psiholoških faktora na doživljavanje boli. Također je dokazana uspješnost kognitivnih metoda za njeno suzbijanje. Ovim istraživanjem željelo se ispitati postoji li razlika u učinkovitosti kognitivnog postupka za suzbijanje boli (distrakcija) i farmakološkog postupka (EMLA kreme) u situaciji vađenja krvi iz vene kod hospitalizirane djece. Naime, rutinski dijagnostički postupci predstavljaju bitan izvor stresa kod takve djece. U praksi se najčeće koriste farmakološke metode suzbijanja boli, koje su skupe, imaju neželjenih nuspojava te su ponekad čak i izrazito komplicirane za uporabu (kao što je slučaj i s EMLA kremom). U istraživanju je sudjelovalo 64 djece (između 10 i 18 godina), koja su bila raspoređena u dvije tretmanske situacije. Tako se u skupini u kojoj se bol suzbijala kognitivnom tehnikom nalazilo 16 dječaka i 15 djevojčica. U skupini u kojoj se koristila farmakološka tehnika, nalazilo se 15 dječaka i 18 djevojčica. Istraživanjem nije nađena statistički značajna razlika u učinkovitosti pojedine tehnike ovisno o spolu, kao ni u učinkovitosti pojedine tehnike uopće. S obzirom na to da je kognitivna tehnika jednostavnija za primjenu, ekonomičnija te da nema poznatih nuspojava, opravdano je njeno korištenje pri suzbijanju boli nastale tijekom vađenja krvi iz vene hospitalizirane djece

ANXIETY AND DEPRESSION IN PAEDIATRIC PATIENTS WITH PAINFUL SOMATIC COMPLAINTS

Cilj istraživanja je bio procijeniti razinu i strukturu anksioznosti i depresivnosti djece i mladih s ponavljanim bolnim tjelesnim tegobama (1) i usporediti ih s vrijednostima normativnog uzorka (2), usporediti bolesnike s pojedinačnim i one s višestrukim tjelesnim tegobama te (3) ispitati proporciju klinički značajno anksioznih i depresivnih bolesnika. Skalom strahova i anksioznosti (SKAD-62) i skalom depresivnosti (SDD) ispitano je 160-ero djece u dobi od 10 do 17 godina, koju su pedijatri uputili psihologu u okviru bolničkog ili ambulantnog liječenja: 57-ero djece s glavoboljama, 24-ero s bolovima u trbuhu, 40-ero s bolovima u prsištu i njih 39-ero s višestrukim tegobama. Rezultati su pokazali kako svi bolesnici imaju sličnu ukupnu razinu anksioznosti i depresivnosti kao i djeca iz normativnog uzorka. Klinički značajna anksioznost registrirana je u 22%, a klinički značajna depresivnost u 4% bolesnika. Najviše je visoko anksiozne djece s bolovima u prsištu (35%), a najmanje s glavoboljama (8,6%). Djeca s višestrukim tjelesnim tegobama ne iskazuju veću anksioznost i depresivnost od one s pojedinačnim tegobama. Između kliničkih skupina iskazana je razlika u dominantnim oblicima anksioznosti: djeca s glavoboljama većinom su separacijski anksiozna, ona s bolovima u trbuhu i u prsištu većinom su anksiozno osjetljiva, a djeca s više tjelesnih tegoba zabrinuta.The aim of this study was to examine the level and different aspects of anxiety and depression in children and youth with recurrent painful somatic complaints and (1) compare them to the norm values of a general population sample, (2) compare the patients with single complaints to patients with multiform somatic complaints and (3) to examine the proportion of clinically significant anxiety and depressive patients. The Fear and Anxiety Scale SKAD-62 and The Depression Scale SDD were applied to 160 children, ages 10 to 17, who were referred by paediatric specialists for psychology assessment under hospital or ambulatory treatment: 56 with headaches, 24 stomach pain sufferers, 40 chest pain sufferer and 39 children with multiple somatic complaints. The results showed that all patients had similar global levels of anxiety and depression as compared to the norm values. Clinically significant anxiety was observed in 22% patients and clinically significant depression in 4% patients. Most anxiety in patients was found in the chest pain group (35%) and less in those with headache (8.6%). Children with multiform complaints are as anxious as single complaint sufferers. A difference was found between clinical samples in different aspects of anxiety symptoms: those with headache were separation anxious, abdominal and chest pain sufferers were more anxiety sensitive, multiform complainers were more worried

Effect of Pyloric Dilatation on Gastric Emptying after Pylorus-Preserving Pancreaticoduodenectomy

Background/Aims: Pylorus-preserving pancreaticoduodenectomy (PPPD) is the standard treatment for periampullary and pancreatic head tumors. Delayed gastric emptying (DGE) is the most common (ranging from 15-45%) but not life threatening complication and impairs patient recovery and prolongs the hospital stay after PPPD. The precise pathomechanism of DGE is still unclear. The aim of this study was to evaluate whether the method of pyloric dilatation performed at the time of PPPD could improve gastric emptying. Methodology: Forty patients underwent PPPD for pancreatic or periampullary lesions from January 1999 to July 2004 were included in this study. In twenty patients mechanical dilatation of the pylorus after duodenal transaction was performed (PPPD+PD group) while in other twenty PPPD was not followed with pyloric dilatation (PPPD group). The incidence of DGE as well as other complications was analyzed. Delayed gastric emptying was defined as gastric stasis requiring nasogastric intubation for more than 4 postoperative days (POD), or the inability to tolerate a regular diet on the 8 th POD. Results: Delayed gastric emptying occurred in seven (35%) out of the 20 patients in the PPPD group, while none of the 20 patients in the PPPD+PD group developed DGE. Conclusions: Pyloric dilatation reduces DGE after PPPD enabling patients to return sooner to a normal diet

Preoperative oral feeding reduces stress response after laparoscopic cholecystectomy

Background/aims: Fasting period before surgery may change metabolic status of the patient and have influence on perioperative stress response. The aim of the study was to investigate effects of preoperative carbohydrate-rich beverage on stress response after laparoscopic cholecystectomy. Methodology: Patients admitted for laparoscopic cholecystectomy were included into study and they were randomized into a group that was fed prior to surgery and in a group that was in the regime of nothing by mouth from the evening one day before surgery. Concentrations of C-reactive protein and cortisol, were measured before and subsequently up to 48 h postoperatively. Results: Postoperative serum C-reactive protein increased significantly in both groups, but the increase was more evident in the group with fasting protocol both 24 and 48 hours postoperatively. In fed patients cortisol concentration measured in the afternoon immediately after the operation showed physiological decline. In patients with fasting protocol postoperative cortisol values rise above the values measured in the morning. Conclusions: Preoperative feeding has advantage over overnight fasting by reducing preoperative discomfort in patients after laparoscopic cholecystectomy. In fed patients, smaller increase in C-reactive protein and better regulation of cortisol levels are an indicator of decreased perioperative stress response

Influence of preoperative oral feeding on stress response after resection for colon cancer

Background/Aims: Preoperative management involves patients fasting from midnight on the evening prior to surgery. Fasting period is often long enough to change the metabolic condition of the patient which increases perioperative stress response. That could have a detrimental effect on clinical outcome. The aim of the present study was to investigate the possible effects of carbohydrate-rich beverage on stress response after colon resection. Methodology: Randomized and double blinded study included 40 patients with colon, upper rectal or rectosigmoid cancer. Investigated group received a carbohydrate-rich beverage the day before and two hours before surgery. In the control group patients were in the standard preoperative regime: nothing by mouth from the evening prior to operation. Peripheral blood was sampled 24h before surgery, at the day of the surgery, and 6, 24 and 4813 postoperatively. Results: Colonic resection in both groups caused a significant increase in serum interleukin 6 (IL-6) levels 6,24 and 4813 after the operation. Increase was more evident and statistically significant in the group with fasting protocol. More significant increase of interleukin 10 (IL-10) occurred in patients who received preoperative nutrition. Conclusions: Smaller increase in IL-6 and higher in IL-10 are indicators of reduced perioperative stress

Influence of preoperative oral feeding on stress response after resection for colon cancer

Background/Aims: Preoperative management involves patients fasting from midnight on the evening prior to surgery. Fasting period is often long enough to change the metabolic condition of the patient which increases perioperative stress response. That could have a detrimental effect on clinical outcome. The aim of the present study was to investigate the possible effects of carbohydrate-rich beverage on stress response after colon resection. Methodology: Randomized and double blinded study included 40 patients with colon, upper rectal or rectosigmoid cancer. Investigated group received a carbohydrate-rich beverage the day before and two hours before surgery. In the control group patients were in the standard preoperative regime: nothing by mouth from the evening prior to operation. Peripheral blood was sampled 24h before surgery, at the day of the surgery, and 6, 24 and 4813 postoperatively. Results: Colonic resection in both groups caused a significant increase in serum interleukin 6 (IL-6) levels 6,24 and 4813 after the operation. Increase was more evident and statistically significant in the group with fasting protocol. More significant increase of interleukin 10 (IL-10) occurred in patients who received preoperative nutrition. Conclusions: Smaller increase in IL-6 and higher in IL-10 are indicators of reduced perioperative stress

Preoperative oral feeding reduces stress response after laparoscopic cholecystectomy

Background/aims: Fasting period before surgery may change metabolic status of the patient and have influence on perioperative stress response. The aim of the study was to investigate effects of preoperative carbohydrate-rich beverage on stress response after laparoscopic cholecystectomy. Methodology: Patients admitted for laparoscopic cholecystectomy were included into study and they were randomized into a group that was fed prior to surgery and in a group that was in the regime of nothing by mouth from the evening one day before surgery. Concentrations of C-reactive protein and cortisol, were measured before and subsequently up to 48 h postoperatively. Results: Postoperative serum C-reactive protein increased significantly in both groups, but the increase was more evident in the group with fasting protocol both 24 and 48 hours postoperatively. In fed patients cortisol concentration measured in the afternoon immediately after the operation showed physiological decline. In patients with fasting protocol postoperative cortisol values rise above the values measured in the morning. Conclusions: Preoperative feeding has advantage over overnight fasting by reducing preoperative discomfort in patients after laparoscopic cholecystectomy. In fed patients, smaller increase in C-reactive protein and better regulation of cortisol levels are an indicator of decreased perioperative stress response

Ružička days : International conference 18th Ružička Days “Today Science – Tomorrow Industry” : Proceedings

Proceedings contains articles presented at Conference divided into sections: chemical analysis and synthesis, chemical and biochemical engineering, food technology and biotechnology, medical chemistry and pharmacy, environmental protection and meeting of young chemists