A systematic review and meta-analysis of the hyperuricemia risk from certain metals.

The relationship between exposure to certain metals and the risk of hyperuricemia (HUA) has biological plausibility, yet prior studies have presented inconsistent findings. We aim to clarify the relationship between exposure to certain metals and HUA using a systematic review and meta-analysis approach. We searched the Web of Science, Embase, MEDLINE, Pubmed, Corchrane and China National Knowledge Infrastructure databases from inception through December, 2021 in order to identify studies that assessed the relationships between metals and the risk of HUA. Data were pooled by random-effects models and expressed as pooled odds ratios (OR) and 95% confidence intervals (CIs). The risk of bias was assessed using a tool from Agency for Healthcare Research and Quality (AHRQ). Twenty eligible articles (nineteen cross-sectional studies and one cohort) were included in our analysis, involving 63,283 participants in total. The studies showed that arsenic (pooled OR = 1.702, 95% CI: 1.44, 2.011; n = 6, I2 = 29.5%), calcium (pooled OR = 1.765, 1.111, 2.804; 4, 82.3%), cadmium (pooled OR = 1.199,1.020, 1.410; 11, 38.5%) and lead (pooled OR = 1.564,1.205, 2.030; 11, 72.9%) exposure were, all linked to an increased risk of HUA. Exposure to molybdenum (pooled OR = 0.804, 0.724, 0.975, 3, 0%) was linked to a decreased risk of HUA, however. Exposure to arsenic, calcium, cadmium and lead is associated with an increased risk of HUA. Molybdenum exposure was associated with a decreased prevalence of HUA; however, aluminum, cobalt, copper, iron, magnesium, manganese, mercury, selenium, thallium and zinc are not associated with HUA risk. Further experimental studies are warranted to decipher the mechanisms by which exposure to the above metals affect HUA risk. The findings reinforced the importance of metals in the HUA risk, and provided a reference for legislation to prevent HUA and protect people's health.

Mental distress and influencing factors in nurses caring for patients with COVID-19.

BACKGROUND: Nurses are experiencing tremendous stress during the new coronavirus disease 2019 (COVID-19) pandemic, especially intensive care nurses. The pandemic of the disease is a tragedy, which may leave a catastrophic psychological imprint on nurses. Understanding nurses' mental distress can help when implementing interventions to mitigate psychological injuries to nurses. AIMS AND OBJECTIVES: To quantify the severity of nurses' post-traumatic stress disorder (PTSD) symptoms and stress and explore the influencing factors of their psychological health when caring for patients with COVID-19. DESIGN: A cross-sectional survey. METHODS: The PTSD Checklist-Civilian and the Perceived Stress Scale were administered from 11 to 18 March 2020, to 90 nurses selected from another city to go and help an intensive care unit (ICU) in Wuhan, China. These nurses were selected because of their high levels of clinical performance and resilience status. RESULTS: Nurses' average PTSD score was 24.62 ± 6.68, and five (5.6%) of the nurses reported a clinically significant level of PTSD symptoms (>38 points). Nurses' perceived stress averaged 19.33 ± 7, and 20 nurses (22.22%) scored positively >25 points. Nurses' stress and PTSD symptoms were positively correlated (P < .01). Major stress sources included working in an isolated environment, concerns about personal protective equipment shortage and usage, physical and emotional exhaustion, intensive workload, fear of being infected, and insufficient work experiences with COVID-19. CONCLUSIONS: This study showed that even relatively highly resilient nurses experienced some degree of mental distress, including PTSD symptoms and perceived stress. Our findings highlight the importance of helping nurses cultivate resilience and reduce stress. RELEVANCE TO CLINICAL PRACTICE: Recommendations for practice include providing adequate training and orientation before assigning nurses to ICU to help, offering disaster-emergency-preparedness training to keep nurses prepared, providing caring and authentic nursing leadership, offering ongoing psychological support to frontline nurses.