Burnout, ansiedade e depressão nos Enfermeiros no contexto de pandemia por COVID-19 / Burnout, anxiety and depression in nurses in the context of a COVID-19 pandemic

O surgimento de um surto pandémico por COVID-19, acresce aos enfermeiros momentos de insatisfação, tensões emocionais e relacionais que podem ser motivadoras para o desenvolvimento de burnout, ansiedade e depressão. Assim desenvolveu-se o estudo com base na temática "Burnout, ansiedade e depressão nos Enfermeiros no contexto de pandemia por COVID-19". O objetivo deste estudo consiste em avaliar o impacto que a pandemia por COVID-19 tem nos enfermeiros, relativamente ao burnout, ansiedade e depressão. Este estudo enquadrase na abordagem de caráter quantitativo descritivo-correlacional, transversal. A amostra, não probabilística por conveniência, foi constituída por um total de 234 enfermeiros. No processo de recolha de dados utilizou-se um questionário estruturado com caracterização sociodemográfica/questões gerais, avaliação dos níveis de ansiedade e depressão obtida através da aplicação da escala Hospital Anxiety and Depression Scale (HADS) - Versão Portuguesa (Pais-Ribeiro et al., 2007), e avaliação dos níveis de burnout através da escala de Copenhagen Burnout Inventory (CBI), adaptada para a população Portuguesa (Fonte, 2011). O local de recolha de dados foi no Hospital do Divino Espírito Santo de Ponta Delgada ­ EPER (HDES-EPER), nos serviços que cumpriam os critérios de inclusão e exclusão, a recolha de dados deu-se no mês de julho de 2021, após parecer favorável da comissão de ética e do conselho de administração da referida instituição. O tratamento dos dados foi efetuado com recurso ao programa SPSS (Statistical Package for the Social Sciences) versão 27 para Windows. Os resultados mostraram que a pandemia por COVID-19 teve um impacto nos enfermeiros relativamente ao burnout, ansiedade e depressão, com a manifestação de níveis de burnout, ansiedade e depressão, independentemente do serviço onde prestam cuidados, sexo e estado civil, não havendo relação direta. Denota-se uma relação entre o desenvolvimento de burnout, ansiedade e depressão com a falta e uso prolongado de material de proteção individual, condições de trabalho desfavoráveis, diminuição da realização profissional, medo de contrair a doença, medo de infetar familiares e amigos, isolamento social, relação com os superiores hierárquicos e amigos. Considerando ainda a remuneração como inadequada e a falta de práticas administrativas, como fatores contributivos para o desenvolvimento de burnout, ansiedade e depressão.

The emergence of a pandemic outbreak by COVID-19, adds to the nurse's moments of dissatisfaction, emotional and relational tensions that can be motivating for the development of burnout, anxiety and depression. Thus, the study was developed based on the theme "Burnout, anxiety and depression in nurses in the context of pandemic by COVID19". The aim of this study is to evaluate the impact that the COVID-19 pandemic has on nurses in relation to burnout, anxiety and depression. This study is based on the descriptivecorrelational, cross-sectional quantitative approach. The sample, non-probabilistic for convenience, consisted of a total of 234 nurses. In the data collection process, we used a structured questionnaire with sociodemographic characterization/general questions, evaluation of anxiety and depression levels obtained through the application of the Hospital Anxiety and Depression Scale (HADS) - Portuguese Version (Pais-Ribeiro et al., 2007), and evaluation of burnout levels through the Copenhagen Burnout Inventory (CBI) scale, adapted for the Portuguese population (Fonte, 2011). The place of data collection was at the HDES-EPER, in the services that met the inclusion and exclusion criteria, the data collection took place in July 2021, after the assent of the ethics committee and the board of directors of that institution. Data were processed using the SPSS version 27 for Windows. The results showed that the pandemic by COVID-19 had an impact on nurses regarding burnout, anxiety and depression, with the manifestation of burnout levels, anxiety and depression, regardless of the service where they provide care, sex and marital status, with no direct relationship. Interrelation is denoted for the development of burnout, anxiety and depression with the lack of personal protective material, unfavorable working conditions, decreased professional achievement, fear of contracting the disease, fear of infecting family and friends, social isolation, relationship with hierarchical superiors and prolonged use of personal protective equipment. The nurses manifested symptoms of generalized anxiety and insomnia, considered inadequate remuneration and lack of administrative practices.

ctDNA on liquid biopsy for predicting response and prognosis in locally advanced rectal cancer: A systematic review.

BACKGROUND: The management of locally advanced rectal cancer (LARC) requires a multidisciplinary approach, with an increasing interest for non-operative strategies. Liquid biopsy for obtaining circulating tumor DNA (ctDNA) can provide information on neoadjuvant chemoradiotherapy (nCRT) pathological response and cancer-specific prognosis, and therefore might be a promising guide for these treatments. METHODS: A systematic review of the studies available in literature has been performed to assess the role of ctDNA as a predictive and prognostic biomarker in LARC patients. RESULTS: We retrieved 21 publications, of which 17 full-text articles and 4 abstracts. Results have been labelled into two groups: predictive and prognostic. Data about the usefulness of liquid biopsy in this setting is still inconclusive. However, baseline higher levels of longer fragments of cell-free DNA and integrity index, tumor-specific mutations and certain methylated genes could predict non-responders. Also, undetectable baseline ctDNA and decrease of common rectal cancer mutations throughout treatment (dynamic monitoring) were predictive factors of pathological complete response. The continuous detection of ctDNA in different timepoints of treatment (minimal residual disease) was consistently associated with worse prognosis. CONCLUSIONS: ctDNA is a promising biomarker that could assist predicting treatment response to nCRT and prognosis in patients with LARC. The ideal methods and timings for the liquid biopsy still have to be defined.

Massive X-ray screening reveals two allosteric drug binding sites of SARS-CoV-2 main protease

The coronavirus disease (COVID-19) caused by SARS-CoV-2 is creating tremendous health problems and economical challenges for mankind. To date, no effective drug is available to directly treat the disease and prevent virus spreading. In a search for a drug against COVID-19, we have performed a massive X-ray crystallographic screen of two repurposing drug libraries against the SARS-CoV-2 main protease (Mpro), which is essential for the virus replication and, thus, a potent drug target. In contrast to commonly applied X-ray fragment screening experiments with molecules of low complexity, our screen tested already approved drugs and drugs in clinical trials. From the three-dimensional protein structures, we identified 37 compounds binding to Mpro. In subsequent cell-based viral reduction assays, one peptidomimetic and five non-peptidic compounds showed antiviral activity at non-toxic concentrations. We identified two allosteric binding sites representing attractive targets for drug development against SARS-CoV-2.

Catalytic cleavage of HEAT and subsequent covalent binding of the tetralone moiety by the SARS-CoV-2 main protease

Here we present the crystal structure of SARS-CoV-2 main protease (Mpro) covalently bound to 2-methyl-1-tetralone. This complex was obtained by co-crystallization of Mpro with HEAT (2-(((4-hydroxyphenethyl)amino)methyl)-3,4-dihydronaphthalen-1(2H)-one) in the framework of a large X-ray crystallographic screening project of Mpro against a drug repurposing library, consisting of 5632 approved drugs or compounds in clinical phase trials. Further investigations showed that HEAT is cleaved by Mpro in an E1cB-like reaction mechanism into 2-methylene-1-tetralone and tyramine. The catalytic Cys145 subsequently binds covalently in a Michael addition to the methylene carbon atom of 2-methylene-1-tetralone. According to this postulated model HEAT is acting in a pro-drug-like fashion. It is metabolized by Mpro, followed by covalent binding of one metabolite to the active site. The structure of the covalent adduct elucidated in this study opens up a new path for developing non-peptidic inhibitors.