Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey.

AIMS: Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. METHODS: 8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. RESULTS: 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. CONCLUSIONS: Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565.

Four-month incidence of suicidal thoughts and behaviors among healthcare workers after the first wave of the Spain COVID-19 pandemic.

Healthcare workers (HCW) are at high risk for suicide, yet little is known about the onset of suicidal thoughts and behaviors (STB) in this important segment of the population in conjunction with the COVID-19 pandemic. We conducted a multicenter, prospective cohort study of Spanish HCW active during the COVID-9 pandemic. A total of n = 4809 HCW participated at baseline (May-September 2020; i.e., just after the first wave of the pandemic) and at a four-month follow-up assessment (October-December 2020) using web-based surveys. Logistic regression assessed the individual- and population-level associations of separate proximal (pandemic) risk factors with four-month STB incidence (i.e., 30-day STB among HCW negative for 30-day STB at baseline), each time adjusting for distal (pre-pandemic) factors. STB incidence was estimated at 4.2% (SE = 0.5; n = 1 suicide attempt). Adjusted for distal factors, proximal risk factors most strongly associated with STB incidence were various sources of interpersonal stress (scaled 0-4; odds ratio [OR] range = 1.23-1.57) followed by personal health-related stress and stress related to the health of loved ones (scaled 0-4; OR range 1.30-1.32), and the perceived lack of healthcare center preparedness (scaled 0-4; OR = 1.34). Population-attributable risk proportions for these proximal risk factors were in the range 45.3-57.6%. Other significant risk factors were financial stressors (OR range 1.26-1.81), isolation/quarantine due to COVID-19 (OR = 1.53) and having changed to a specific COVID-19 related work location (OR = 1.72). Among other interventions, our findings call for healthcare systems to implement adequate conflict communication and resolution strategies and to improve family-work balance embedded in organizational justice strategies.

[Detection of adverse events in thyroid and parathyroid surgery using trigger tool and Minimum Basic Data Set (MBDS)]. / Detección de eventos adversos en la cirugía tiroidea y paratiroidea utilizando la herramienta trigger y el Conjunto Mínimo de Datos Básicos (CMBD).

OBJECTIVES: To compare the ability of the trigger tool) and the Minimum Basic Data Set (MBDS) in detecting adverse events (AE) in hospitalized surgical patients with thyroid and parathyroid disease. METHODS: A descriptive, cross-sectional observational study, retrospective and cross-sectional study was conducted from May 2014 to April 2015 analysing retrospectively data on of patients submitted to thyroidectomy and parathyroidectomy in order to detect AE through the identification of triggers (an event often associated to an AE) and the MBDS. triggers and AE were located by systematic review of clinical documentation. The MBDS was got from the data base. Once an AE was detected, it was characterized. RESULTS: 203 AE were identified in 251 patients, being the 90.04% detected by trigger tool and 10.34% by MBDS. 126 patients had at least one AE (50.2%). Without the cases in which uncontrolled pain was the only AE, the percentage of patients that suffering AE was 38.65%. 187 AE were considered preventable and 16 AE were considered unpreventable. The trigger tool and the MBDS demonstrated a sensitivity of 91.27 and 13.49%, a specificity of 4.8 and 100%, a positive predictive value of 49,15 and 100%, and a negative predictive value of 35.29 and 53.42%, respectively. The triggers with more predictive power in AE detection were «antiemetic administration¼ and «calcium administration¼. CONCLUSIONS: Trigger tool shows higher sensitivity for detecting AE than the MBDS. All the detected AE were considered low severity and most of them were preventable.

[Comparison of the "Trigger" tool with the minimum basic data set for detecting adverse events in general surgery]. / Comparación de la herramienta Trigger con el conjunto mínimo básico de datos (CMBD) para la detección de eventos adversos en cirugía general.

INTRODUCTION: Surgery is a high risk for the occurrence of adverse events (AE). The main objective of this study is to compare the effectiveness of the Trigger tool with the Hospital National Health System registration of Discharges, the minimum basic data set (MBDS), in detecting adverse events in patients admitted to General Surgery and undergoing surgery. MATERIAL AND METHODS: Observational and descriptive retrospective study of patients admitted to general surgery of a tertiary hospital, and undergoing surgery in 2012. The identification of adverse events was made by reviewing the medical records, using an adaptation of "Global Trigger Tool" methodology, as well as the (MBDS) registered on the same patients. Once the AE were identified, they were classified according to damage and to the extent to which these could have been avoided. The area under the curve (ROC) were used to determine the discriminatory power of the tools. The Hanley and Mcneil test was used to compare both tools. RESULTS: AE prevalence was 36.8%. The TT detected 89.9% of all AE, while the MBDS detected 28.48%. The TT provides more information on the nature and characteristics of the AE. The area under the curve was 0.89 for the TT and 0.66 for the MBDS. These differences were statistically significant (P<.001). CONCLUSIONS: The Trigger tool detects three times more adverse events than the MBDS registry. The prevalence of adverse events in General Surgery is higher than that estimated in other studies.

Formation of copper oxychloride and reactive oxygen species as causes of uterine injury during copper oxidation of Cu-IUD.

The lining of the uterus and cervix might be injured by a variety of oxidation products of Cu in a Cu-IUD, including cuprous ions, dissolved and precipitated cupric ions, and reactive oxygen species such as superoxide radicals, hydrogen peroxide, and hydroxyl radicals. In this study, the human amnious WISH cell line was employed as a model of uterine cells in the presence of copper. The cell viability was decreased by elemental copper, which was alleviated up to 70% by the addition of catalase. The addition of copper oxychloride caused cell death in a dose-dependent manner. Hydroxyl radicals in the presence of copper were determined by the formation of malondialdehyde. Soluble cuprous chloride complexes are formed in the uterus by slowly entering oxygen. The complexes are partly oxidized to insoluble copper oxychloride. which damages the endometrium. Unoxidized cuprous ions migrate to the oxygen-rich cervix and are oxidized to copper oxychloride, causing cervix damage.

In vitro study of biosynthesis of protoporphyrin IX induced by delta-aminolevulinic acid in normal and cancerous cells of the human cervix.

BACKGROUND: delta-Aminolevulinic acid (ALA) is recognized as the starter in the biosynthesis of the heme group, the structural basis of cytochromes, chlorophylls, biliary pigments, and other porphyrins. It is the first intermediary in the biosynthesis of protoporphyrin IX (PpIX), and of the heme group. PpIX is present in low concentration in normal cells, and in high concentration in tumor cells. METHODS: The accumulation of protoporphyrin IX (PpIX) induced by delta-aminolevulinic acid (ALA) was tested in two cervico-uterine cancer cell lines (HeLa and CaLo), and in normal human cervical epithelial (NHCE) cells. RESULTS: The optimal concentration of ALA that induced maximum levels of intra- and extracellular accumulation of PpIX in both HeLa and NHCE cells was 300 micrograms of ALA/mL, and for CaLo cells, 150 micrograms/mL. The viability of HeLa, CaLo, and NHCE cells exposed to ALA measured 81, 98, and 84%, respectively. The optimal time for accumulation of PpIX, both intra- and extracellular, was 4 h for HeLa and NHCE cells and 5 h for CaLo cells per 24 h of exposure to optimal concentrations of ALA. After the maximum level of PpIX accumulation was reached, there was a gradual decrease until there was only a small quantity. A statistically significant difference (p < 0.0001) was found in the accumulation of PpIX, depending on the concentrations of ALA used as well as between cervical cancer cell lines and NHCE cells (p < 0.0001). The concentration ratio of PpIX for NHCE and HeLa cells was 1:7, and for NHCE and CaLo cells, 1:5. CONCLUSIONS: These results are important for determining the usefulness of the sensitizer (PpIX).

Genome composition in Venezuelan spiny-rats of the genus Proechimys(Rodentia, Echimyidae). I. Genome size, C-heterochromatin and repetitive DNAs in situ hybridization patterns.

The genome sizes of the Venezuelan spiny-rats Proechimys guairae guairae (2n = 48) and P. trinitatis (2n = 62) were evaluated and proved to be 12.5 +/- 0.5 pg and 12.6 +/- 0.3 pg respectively, the highest so far recorded among mammals; also the C-heterochromatin (32.7%, Coefficient of Variation [CV] 3.8 and 35.8%, CV 4.4) and GC (44.2%, CV 2.7 and 43.6%, CV 2.9) contents are very high. Highly repetitive (rep) DNAs were isolated from restriction enzyme digested genomic DNAs of both species. The intra- and inter-specific chromosomal allocations of these rep DNAs were analyzed by direct and cross-hybridizations. Results show that the two genomes harbour several rep DNA families which show both species-specificity and interspecific relatedness in their in situ hybridization patterns. The rep DNA families show an equilocal distribution at both the pericentromeric areas of all chromosomes and in the whole arms of two pairs of the uniarmed group, suggesting co-evolution of the rep DNAs. P. g. guairae BamHI digested DNA, when cloned and sequenced, proved to consist of a long "composite" unit (1,239 bp) containing two copies of each of 75-bp and 110-bp internal subrepeats. Karyotype restructuring between P. g. guairae and P. trinitatis, mainly due to Robertsonian changes, was accompanied by slight intra- and intergenomic movements of the putative satellite DNA families within stable genome sizes and C-heterochromatin contents. We discuss the findings obtained in Proechimys in the light of those regarding the kangaroo rat, the pocket gopher and the house mouse; they support the idea that karyotype restructuring could be the expression of molecular driven events of rep DNA amplification and homogenisation through non-homologous chromosomes.

Cytogenetics and karyosystematics of Oryzomys albigularis (Rodentia, Cricetidae) from Venezuela.

Several authors have proposed that Oryzomys albigularis constitutes a supraspecific complex and that chromosomal pericentromeric inversions have played a fundamental role in the diversifying process. With the purpose of clarifying the unclear taxonomic situation of the nominal forms of O. albigularis living in Venezuela, a cytogenetic study was carried out on individuals from five different localities along the Andean range and the Cordillera de la Costa. All of the individuals examined showed a diploid number (2n) of 66 chromosomes, but there were differences in the number of autosomal arms (FN = 90, 92, and 104) and in the morphology of the X chromosome (metacentric or acrocentric). The C-banding pattern was similar in all populations, autosomal heterochromatin was restricted to the centromere, and the Y chromosome was the only one that had completely heterochromatic arms. G-banding was useful in making arm-to-arm comparison between the FN = 90 and FN = 104 karyomorphs; 23 shared pairs were found, 7 pairs differed due to pericentric inversions, and 3 pairs had no correspondence. We postulate that these karyomorphs probably correspond to allospecies, and that the specific denominations must correspond to two previously recognized populations of sigmodontine rodents: O. caracolus Thomas 1914 (2n = 66, FN = 90), for the populations from the Cordillera de la Costa, and O. meridensis Thomas 1894 (2n = 66, FN = 104), for the populations distributed between the middle and extreme north of the Andean range. The specific denomination for the populations of animals from the southern portion of the Andean range (Oryzomys sp., 2n = 66, FN = 92) is still to be determined.

Cytogenetics and karyosystematics of South American oryzomyine rodents (Cricetidae: Sigmodontinae). IV. Karyotypes of Venezuelan, Trinidadian, and Argentinian water rats of the genus Nectomys.

Bone marrow chromosomes were studied in South American water rats of the genus Nectomys from Venezuela, Trinidad, and Argentina. Specimens of N. squamipes from western and southern Venezuela showed a 2n = 52-53 karyotype, whereas a 2n = 56-57 karyotype was found in specimens from northeastern Argentina. In both cases, odd karyotypes can be explained by the presence of a supernumerary chromosome. In contrast, water rats from northeastern Venezuela and Trinidad showed a strikingly reduced 2n = 16-17 polymorphic chromosome complement. Six different karyomorphs were found among the latter, which may have resulted from a combination of pericentric inversions in two pairs of autosomes and a centromeric fusion in another autosomal pair. It is proposed that the new 2n = 16-17 cytotypes belong to a species of its own, for which the name N. palmipes is suggested.

[Neurocomportmental disorders in an urban population exposed to lead]. / Troubles neurocomportementaux dans une population urbaine exposée au plomb.

A study was performed in 278 people living in a Mexican town with a high lead environmental pollution. Lead blood level was found very high (m:59.7 micrograms/l) and some abnormalities were also found for free erythrocyte Protoporphyrin and ALA dehydratase. A significant dose-response relationship was also found with somatic complaints like loss of appetite, insomnia and headache.

[Karyotyping of Holochilus venezuelae (Rodentia, Cricetidae)]. / Cariología de Holochilus venezuelae (Rodentia, Cricetidae).

We studied the cariotype of Holochilus venezuelae from 28 individuals (14 males and 14 females). Chromosome preparations were obtained by applying colchicine to live animals, followed by hypotonic shock, acetic methanol fixation and Giemsa staining of bone marrow cells. Metaphase configurations were photographed with a M-20 Wild automatic photomicroscope, and 10 karyotype from each animal were prepared from enlarged prints. Idiograms were calculated from the mean length of each chromosome pair and expressed as percentage of the length of the haploid autosome set plus one X chromosome. Results indicate the presence of six karyomorphs and the most frequent karyotype, considered basic for the species, was 2n = 44 (NF = 56), which consists of seven pairs of metacentric chromosomes (five large, one small and one microchromosome), comprising 59.5% of the haplid set; fourteen acrocentric pairs (nine small and five microchromosomes) representing 32.0% of the set; and the sexual pair, which is acrocentric, represent 6% (X) and 2.5% (Y) of the haploid set. The chromosome polymorphisms can be interpreted as the result of Robertsonian changes (fusion) and from the presence of accessory chromosomes (supernumerary). The karyotypical characteristics of the population sample studied suggest the existence of reproductive isolation through chromosomal hybrid sterility with H. brasiliensis (2n = 56 and 2n = 50), which means that H. venezuelae can be considered an allospecie.