Stress reactions in a tertiary oto-rhino-laryngological department during the first wave of the COVID-19 pandemic in the Danish Capital region.

BACKGROUND: Health care workers (HCW) at otorhinolaryngological departments have an increased risk of contracting COVID-19, due to aerosol-inducing diagnostic and surgical procedures in the airways. The ongoing exposure to physical and psychological stressors could impact the mental health of HCW. AIM/OBJECTIVE: To investigate the impact on mental health in an otorhinolaryngological department during the COVID-19 pandemic. MATERIALS/METHOD: Cross-sectional questionnaire study, assessing symptoms of depression (PHQ-9) and anxiety (GAD-10). Physicians, nurses, and secretaries were included at a tertiary department of otorhinolaryngology in the Capital Region of Denmark during the COVID-19 lockdown in spring 2020. RESULTS: Positive screenings for stress reactions were found in 22% for depressive symptoms and 15.5% anxiety. 27% feared becoming infected, 47% feared infecting their families in relation to work. 27% felt others were distancing from them, and 38% isolated themselves from others because of their work. Women had an odds ratio of 9.18 (CI 1.49-179) for depressive stress reactions. CONCLUSION: HCW were primarily concerned with transmitting COVID-19 to their relatives. Secondarily, there was a concern about becoming infected despite feeling adequately protected by personal protective equipment. Women were at higher risk of more severe depressive symptoms when corrected for professions.

The impact of the COVID-19 pandemic on mental health among healthcare workers in ear-nose-throat clinics.

INTRODUCTION: During the first wave of the COVID-19 pandemic, it was established that otorhinolaryngologists were at a high risk of contracting the infection due to examinations of the upper airways. The aim of this study was to evaluate the impact of the COVID-19 pandemic on mental health among healthcare workers (HCWs) in primary ear-nose-throat (ENT) practices. METHODS: This was a cross-sectional questionnaire study among HCWs assessing symptoms of anxiety (Generalized Anxiety Disorder, ten-item scale) and depression (Patients Health Questionnaire, nine-item scale). The survey targeted otolaryngologists and staff in primary private practices in the Capital Region of Denmark during the COVID-19 lock-down in May 2020. RESULTS: For 30% of the participants, signs were observed of depressive symptoms and 13% had signs of anxiety symptoms. Seventy percent felt sufficiently protected by their available personal protective equipment. Fifty-two percent worried about becoming infected in relation to their work and 56% feared infecting their families. CONCLUSIONS: HCWs in Danish primary ENT practices did not display extraordinary stress reactions during the first wave of the pandemic. Noticeably, participants were concerned about acquiring the infection or transmitting it to their household. FUNDING: none. TRIAL REGISTRATION: not relevant.

Neutrophil gelatinase associated lipocalin a biomarker for bacterial-induced pharyngeal infection-A pilot study.

OBJECTIVES: Neutrophil gelatinase associated lipocalin (NGAL) is secreted from activated neutrophil granulocytes and is considered an acute phase protein. The aim of this pilot study was to determine whether the NGAL concentration in saliva increases in response to a bacterial throat infection and identify pitfalls, which shall be taken into account in a protocol in a larger hypothesis testing study. METHODS: Saliva samples for measurement of NGAL concentration where obtained from cases with an acute throat infection (n = 21) and controls (n = 24). Among cases, plasma NGAL, plasma CRP, and whole blood leukocytes, were measured as well. RESULTS: There was no significant difference in NGAL saliva concentration between cases and controls overall (p = .31). For both cases and controls, the saliva NGAL concentration decreased significantly after cleansing the mouth with tap water (cases p = .01; controls p = .01). Among cases, a significant positive correlation between saliva NGAL concentrations before mouth cleansing and plasma CRP concentrations (p = .001) was observed. Blood neutrophil granulocyte count presented a nonsignificant positive correlation to saliva NGAL (p = .07). CONCLUSION: We could not demonstrate a simple association between the salivary NGAL concentration and pharyngeal bacterial infection. Furthermore, the salivary NGAL concentrations were higher among some controls than cases, suggesting that cofounders for example, periodontitis, uneven salivary dilution level, or other exogenous factors affect salivary NGAL content.

The association between human papillomavirus and oropharyngeal squamous cell Carcinoma: Reviewed according to the Bradford Hill criteria for causality.

There is emerging evidence of the association between human papillomavirus and a subset of head and neck cancers. However, the role of human papillomavirus as a causal factor is still debated. This review addresses the association between human papillomavirus and oropharyngeal squamous cell carcinoma using the Bradford Hill criteria. The strength of the association is supported by, detection of human papillomavirus infection and antibodies prior to oropharyngeal squamous cell carcinoma. This is furthermore reinforced by the absence of human papillomavirus DNA in healthy tonsils. The association is geographically consistent throughout the economically developed world. The presence and integration of high-risk human papillomavirus genome in tonsillar tumours, and expression of viral oncogenes, are specific and plausible. Analogous to human papillomavirus in cervical cancer, the rising incidence in human papillomavirus positive oropharyngeal squamous cell carcinoma is associated with sexual behaviour. These associations have been repeatedly observed and are in accordance with our current knowledge. The time relation between cause and effect remains the main challenge, due to the lack of well-defined premalignant lesions. However, a causal relationship between human papillomavirus infection and oropharyngeal squamous cell carcinoma seems evident.