Impact of COVID-19 on mental health of health care workers in Spain: a mix-methods study.

BACKGROUND: Spain's lockdown measures couldn't prevent the severe impact of the COVID-19 first wave, leading to high infections, deaths, and strain on healthcare workers (HCWs). This study aimed to explore the mental health impact on HCWs in the Balearic Islands during the initial months of the pandemic, the influencing factors, and the experiences of those in a COVID-19 environment. METHODS: Using a mixed-methods approach, the study encompassed quantitative and qualitative elements. Cross-sectional survey data from April to June 2020 comprised HCWs who were emailed invitations. The survey covered demographics, work, clinical and COVID-19 variables, along with psychological distress and PTSD symptoms, using validated measures. Additionally, semi-structured interviews with HCWs offered qualitative insights. RESULTS: Three hundred thirty-six HCWs averaging 46.8 years, mainly women (79.2%), primarily nurses in primary care with over 10 years of experience. Anxiety symptoms were reported by 28.8%, 65.1% noted worsened sleep quality, and 27.7% increased psychoactive drug usage. Psychological distress affected 55.2%, while 27.9% exhibited PTSD symptoms. Gender, age, experience, COVID-19 patient contact, and workload correlated with distress, PTSD symptoms, sleep quality, and psychoactive drug usage. Interviews uncovered discomfort sources, such as fear of infection and lack of control, leading to coping strategies like information avoidance and seeking support. LIMITATIONS: Static cross-sectional design, non-probabilistic sample, and telephone interviews affecting non-verbal cues, with interviews conducted during early pandemic lockdown. CONCLUSIONS: HCWs faced significant psychological distress during the pandemic's first wave, underscoring the necessity for robust support and resources to counteract its impact on mental health.

Nódulo de la Hermana María José. Manifestación inicial de un carcinoma de ovario / Sister Mary Joseph’s nodule. A first manifestation of ovarian carcinoma

Las metástasis umbilicales de neoplasias malignas (también denominadas nódulo de la Hermana María José) son un suceso raro que normalmente se considera un signo de mal pronóstico. A pesar de ello, el tiempo de supervivencia puede alargarse con un tratamiento agresivo que combine la cirugía y la quimioterapia. Se presenta un caso de metástasis umbilical como manifestación inicial de un carcinoma de ovario, tratado con una óptima cirugía debulking y quimioterapia, y con seguimiento regular desde la operación. La paciente continúa en remisión clínica completa, su estado general es bueno y, 36 meses después, los marcadores tumorales se mantienen en valores normales (AU)

Umbilical metastases from malignant neoplasms, also termed Sister Mary Joseph's nodule, are rare and have usually been considered as a sign of poor prognosis. However, patient survival time could be lengthened by aggressive therapy that combines surgery with chemotherapy. We report a case of umbilical metastases as the presenting symptom of an ovarian carcinoma. Treatment consisted of optimal debulking surgery plus chemotherapy and regular postoperative follow-up was performed. The patient has been in complete clinical remission with good performance status and normal levels of serum tumor markers for 36 months (AU)

Role of protein kinase A in human hepatocyte DNA synthesis.

The cellular mechanisms associated with the replicative response of hepatocytes to growth factor simulation is incompletely understood. Murine hepatocyte DNA synthesis is altered by cyclic AMP, suggesting that protein kinase A is involved in the cellular mechanisms associated with liver growth. The purpose of this study was to evaluate the role of protein kinase A in human hepatocyte DNA synthesis. human hepatocytes were isolated and maintained in primary culture on rat tail collagen. DNA synthesis was evaluated by determining [3H] thymidine incorporation. Human hepatocytes between 24 and 96 hr following harvest increased DNA synthesis in response to epidermal growth factor but not in response to glucagon, a stimulant of adenyl cyclase, or dibutyryl cyclic AMP. Mitogen-stimulated DNA synthesis was decreased by dibutyryl cyclic AMP. Cyclic AMP isomers that block or stimulate the effect of cyclic AMP on protein kinase A did not significantly alter resting or mitogens-stimulated human hepatocyte DNA synthesis. The results suggest that increased protein kinase A activity does not produce human hepatocyte replicative DNA synthesis.