Factores asociados al impacto emocional de la pandemia por Covid-19 en profesionales sanitarios / [Factors associated with the emotional impact of the Covid-19 pandemic on health professionals]

El objetivo de este trabajo fue explorar el impacto emocional de la Covid-19 en profesionales sanitarios del Hospital Clínico Universitario de Valencia, e identificar las variables asociadas. Participaron 228 profesionales que cumplimentaron en mayo de 2020 una encuesta online elaborada ad hoc. Los profesionales sanitarios experimentaron síntomas de estrés (32%), depresión (26%), ansiedad (14%) y recuerdos intrusos (7,5%). Se observó mayor frecuencia de tristeza y ansiedad en mujeres y en profesionales que habían presentado síntomas de Covid-19. La categoría profesional con síntomas emocionales más frecuentes fue el de auxiliar de enfermería, y para estrés también enfermeros y residentes. Las unidades con mayor afectación fueron las de primera línea. Las variables psicológicas que se asociaron negativamente con la frecuencia de todas las manifestaciones sintomáticas fueron: autocuidado, autoestima, resiliencia y uso de estrategias de afrontamiento activas, junto a autoeficacia y apoyo social para estrés y depresión. Pese a las limitaciones del estudio, los resultados pueden contribuir a orientar programas preventivos para profesionales sanitarios en futuras crisis sanitarias.

The aim of this study was to explore the emotional impact of Covid-19 on healthcare professionals at the Clinical and University Hospital of Valencia (Spain), and to identify the associated variables. A total of 228 professionals completed an ad hoc online survey in May 2020. The healthcare professionals experienced symptoms of stress (32%), depression (26%), anxiety (14%) and intrusive memories (7.5%). A higher frequency of sadness and anxiety was observed in women and in professionals who had presented Covid-19 symptoms. The professional category with the most frequent emotional symptoms was that of auxiliary nurses, and for stress also nurses and residents. The most affected were the first line units. The psychological variables that were negatively associated with the frequency of all symptomatic manifestations were: self-care, self-esteem, resilience and use of active coping strategies, together with self-efficacy and social support for stress and depression. Despite the limitations of the study, the results may contribute to guide preventive programs for health professionals in future health crises.

Polymorphism of the Transcription Factor 7-Like 2 Gene (TCF7L2) Interacts with Obesity on Type-2 Diabetes in the PREDIMED Study Emphasizing the Heterogeneity of Genetic Variants in Type-2 Diabetes Risk Prediction: Time for Obesity-Specific Genetic Risk Scores.

Nutrigenetic studies analyzing gene-diet interactions of the TCF7L2-rs7903146 C > T polymorphism on type-2 diabetes (T2D) have shown controversial results. A reason contributing to this may be the additional modulation by obesity. Moreover, TCF7L2-rs7903146 is one of the most influential variants in T2D-genetic risk scores (GRS). Therefore, to increase the predictive value (PV) of GRS it is necessary to first see whether the included polymorphisms have heterogeneous effects. We comprehensively investigated gene-obesity interactions between the TCF7L2-rs7903146 C > T polymorphism on T2D (prevalence and incidence) and analyzed other T2D-polymorphisms in a sub-sample. We studied 7018 PREDIMED participants at baseline and longitudinally (8.7 years maximum follow-up). Obesity significantly interacted with the TCF7L2-rs7903146 on T2D prevalence, associations being greater in non-obese subjects. Accordingly, we prospectively observed in non-T2D subjects (n = 3607) that its association with T2D incidence was stronger in non-obese (HR: 1.81; 95% CI: 1.13-2.92, p = 0.013 for TT versus CC) than in obese subjects (HR: 1.01; 95% CI: 0.61-1.66; p = 0.979; p-interaction = 0.048). Accordingly, TCF7L2-PV was higher in non-obese subjects. Additionally, we created obesity-specific GRS with ten T2D-polymorphisms and demonstrated for the first time their higher strata-specific PV. In conclusion, we provide strong evidence supporting the need for considering obesity when analyzing the TCF7L2 effects and propose the use of obesity-specific GRS for T2D.

[SHORT TERM EFFECTS ON LIPID PROFILE AND GLYCAEMIA OF A LOW-FAT VEGETARIAN DIET]. / EFECTOS A CORTO PLAZO EN EL PERFIL LIPÍDICO Y LA GLUCEMIA DE UNA DIETA VEGETARIANA BAJA EN GRASA.

INTRODUCTION: vegetarian diets have been associated with lower risk of cardiovascular disease and a more favourable lipid profile in vegetarians who follow these diets for a long term period in observational studies, but the short-term effects of vegetarian diets are less known. OBJECTIVE: our objective was to analyze the short-term effects of a low-fat vegetarian diet on lipid profile and fasting glucose in previously non-vegetarian subjects from a Mediterranean population. METHODS: we carried out a nutritional intervention study in 159 volunteers (42 men and 117 women). A whole lacto-vegetarian diet low in fat (20%) was administered. A full daily menu was provided for 15 days under strict interned conditions. Fasting blood samples were obtained before and after dietary intervention and total cholesterol, HDL-C, LDL-C, triglycerides and fasting glucose were determined. Multivariate models for repeated measures were used. RESULTS: after dietary intervention, we detected statistically significant reductions in total cholesterol (-17.54 ± 37.14 mg/dl), LDL-C (-9.33 ± 34.29 mg/dl), HDL-C (-5.32 ± 12.16 mg/dl), and triglycerides (-18.92 ± 50.50 mg/dl). These reductions remained statistically significant after adjustment for sex and age. Significant weight changes were also detected. The additional adjustment for changes in body mass index (BMI) attenued the significance of the decrease in triglycerides (P = 0.067). CONCLUSION: a lacto-vegetarian diet low in fat, produces favourable and significant decreases in total cholesterol, LDL-C (independent of weight loss) and triglycerides (mediated by weight loss). This intervention also produced an expected decrease in HDL-C due to its reduced fat content.

Introducción: en estudios observacionales, las dietas vegetarianas se han asociado con menor riesgo de enfermedad cardiovascular y un perfil lipídico más favorable en las personas que siguen estas dietas a largo plazo pero sus efectos a corto plazo son menos conocidos. Objetivo: analizar el efecto a corto plazo en población mediterránea previamente no vegetariana de una dieta vegetariana baja en grasas sobre el perfil lipídico y la glucemia. Métodos: se realizó un estudio de intervención nutricional en 159 voluntarios (42 hombres y 117 mujeres) administrando un patrón de dieta completa lacto-vegetariana baja en grasa (20%). Se proporcionó un menú diario completo en condiciones de régimen de internado estricto durante 15 días. Se realizaron extracciones de sangre en ayunas antes y después de la intervención dietética y se determinó el colesterol total, C-HDL, C-LDL, triglicéridos y glucemia. Se emplearon modelos multivariantes de medidas repetidas. Resultados: tras la intervención dietética se detectaron reducciones estadísticamente significativas en el colesterol total (-17,54 ± 37,14 mg/dl), C-LDL (-9,33 ± 34,29 mg/ dl), C-HDL (-5,32 ± 12,16 mg/dl), y triglicéridos (-18,92 ± 50,50 mg/dl) que permanecieron tras ajustar por edad y sexo. También se produjeron cambios significativos de peso. El ajuste adicional por los cambios en el índice de masa corporal (IMC) restó significación a la disminución de los triglicéridos (P = 0.067). Conclusión: la dieta lacto-vegetariana baja en grasa a corto plazo produce descensos favorables y significativos de colesterol total, C-LDL (independientes de la pérdida de peso) y triglicéridos (mediados por la pérdida de peso). También produjo un descenso esperable de C-HDL al ser reducida en grasa.

Efectos a corto plazo en el perfil lipídico y la glucemia de una dieta vegetariana baja en grasa / Short term effects on lipid profile and glycaemia of a low-fat vegetarian diet

Introducción: en estudios observacionales, las dietas vegetarianas se han asociado con menor riesgo de enfermedad cardiovascular y un perfil lipídico más favorable en las personas que siguen estas dietas a largo plazo pero sus efectos a corto plazo son menos conocidos. Objetivo: analizar el efecto a corto plazo en población mediterránea previamente no vegetariana de una dieta vegetariana baja en grasas sobre el perfil lipídico y la glucemia. Métodos: se realizó un estudio de intervención nutricional en 159 voluntarios (42 hombres y 117 mujeres) administrando un patrón de dieta completa lacto-vegetariana baja en grasa (20%). Se proporcionó un menú diario completo en condiciones de régimen de internado estricto durante 15 días. Se realizaron extracciones de sangre en ayunas antes y después de la intervención dietética y se determinó el colesterol total, C-HDL, C-LDL, triglicéridos y glucemia. Se emplearon modelos multivariantes de medidas repetidas. Resultados: tras la intervención dietética se detectaron reducciones estadísticamente significativas en el colesterol total (-17,54 ± 37,14 mg/dl), C-LDL (-9,33 ± 34,29 mg/ dl), C-HDL (-5,32 ± 12,16 mg/dl), y triglicéridos (-18,92 ± 50,50 mg/dl) que permanecieron tras ajustar por edad y sexo. También se produjeron cambios significativos de peso. El ajuste adicional por los cambios en el índice de masa corporal (IMC) restó significación a la disminución de los triglicéridos (P = 0.067). Conclusión: la dieta lacto-vegetariana baja en grasa a corto plazo produce descensos favorables y significativos de colesterol total, C-LDL (independientes de la pérdida de peso) y triglicéridos (mediados por la pérdida de peso). También produjo un descenso esperable de C-HDL al ser reducida en grasa (AU)

Introduction: vegetarian diets have been associated with lower risk of cardiovascular disease and a more favourable lipid profile in vegetarians who follow these diets for a long term period in observational studies, but the short-term effects of vegetarian diets are less known. Objective: our objective was to analyze the short-term effects of a low-fat vegetarian diet on lipid profile and fasting glucose in previously non-vegetarian subjects from a Mediterranean population. Methods: we carried out a nutritional intervention study in 159 volunteers (42 men and 117 women). A whole lacto-vegetarian diet low in fat (20%) was administered. A full daily menu was provided for 15 days under strict interned conditions. Fasting blood samples were obtained before and after dietary intervention and total cholesterol, HDL-C, LDL-C, triglycerides and fasting glucose were determined. Multivariate models for repeated measures were used. Results: after dietary intervention, we detected statistically significant reductions in total cholesterol (-17.54 ± 37.14 mg/dl), LDL-C (-9.33 ± 34.29 mg/dl), HDL-C (-5.32 ± 12.16 mg/dl), and triglycerides (-18.92 ± 50.50 mg/dl). These reductions remained statistically significant after adjustment for sex and age. Significant weight changes were also detected. The additional adjustment for changes in body mass index (BMI) attenued the significance of the decrease in triglycerides (P = 0.067). Conclusion: a lacto-vegetarian diet low in fat, produces favourable and significant decreases in total cholesterol, LDL-C (independent of weight loss) and triglycerides (mediated by weight loss). This intervention also produced an expected decrease in HDL–C due to its reduced fat content (AU)

Respuesta: Acerca de "Efectos a corto plazo en la pérdida de peso de una dieta vegetariana baja en grasa" / Reply: About "Short term effects on weight loss of a low-fat vegetarian diet"

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