COVID-19 distress affects healthcare and administrative workers equally at a tertiary hospital center in Brazil.

Introduction: The COVID-19 outbreak exposes healthcare workers to an increased risk of distress and psychiatric symptoms. Objectives: To evaluate psychological suffering and mental disorders among healthcare workers at a tertiary hospital, a referral center for COVID-19 treatment. Methods: An observational, cross-sectional, quantitative study with descriptive methodology. Fifty-eight healthcare workers who attended consultations at the hospital's Mental Health Outpatient Clinic were included. The study was carried out after approval by the research ethics committee at the Faculdade de Medicina de São José do Rio Preto (32665020.3.0000.5415). Results: 81% were women, mean age was 38.98±10.6 years, 20 (34.5%) were administrative staff, 24 (41.4%) were attending a first consultation, and 28 had had previous psychiatric attention at other services. Sixteen (28%) reported new symptoms during the pandemic, with anxious (10), irritable (3), and depressive (2) symptoms being the most frequent. Anxiety (26) and depressive disorders (19) were the most prevalent. As for exposure to news, the most common feelings were fear (19) and anguish or concern (9). The most common feelings associated with the pandemic were fear and recurrent thoughts of social and economic impact (27). The main reflections were about the meaning of life (17), human vulnerability (11), and the importance of the family (7). Regarding prospects for the future, 70.7% (41) reported hope for improvement. Conclusions: Initial data suggest a high prevalence of anxiety and depressive symptoms, as well as sleep disturbances, regardless of work team. Fear of death and uncertainty about the future are also prevalent. These data reinforce the importance of developing strategies to reduce the risks to this population's mental health.

Male with myelofibrosis and ulceronecrotic lesions.

OBJECTIVE: Granulocytic sarcoma also called myeloid sarcoma is an extramedullary tumour of immature granulocytic cells. It is a rare entity, and mostly accompanied by acute myeloid leukaemia. It is observed during the course of myeloproliferative disorders especially in chronic myeloid leukaemia and myelodysplastic syndromes. CONCLUSIONS: Here, we report a case of a 60-year-old male with past history of myelofibrosis admitted to the emergency room due ulceronecrotic lesions, fever and dysphagia. We emphasize the importance of recognizing this entity and its severity.

Male with myelofibrosis and ulceronecrotic lesions

SUMMARY Granulocytic sarcoma also called myeloid sarcoma is an extramedullary tumour of immature granulocytic cells. It is a rare entity, and mostly accompanied by acute myeloid leukaemia. It is observed during the course of myeloproliferative disorders especially in chronic myeloid leukaemia and myelodysplastic syndromes. Here, we report a case of a 60-year-old male with past history of myelofibrosis admitted to the emergency room due ulceronecrotic lesions, fever and dysphagia. We emphasize the importance of recognizing this entity and its severity.

RESUMO O sarcoma granulocítico, também chamado de sarcoma mieloide, é um tumor extramedular de células granulocíticas ¡maturas. É uma entidade rara, e principalmente acompanhada de leucemia mieloide aguda. É observado durante o transtorno mieloproliferativo, especialmente na leucemia mieloide crónica e síndromes mielodisplásicas. Aqui, relatamos um caso de um homem de 60 anos com antecedente de mielofibrose admitida na sala de emergência devido a lesões ulceronecróticas, febre e disfagia. Enfatizamos a importância de reconhecer essa entidade e sua gravidade.

Plasma levels of trans-fatty acids are low in exclusively breastfed infants of adolescent mothers.

The purpose of this study was to determine the levels of trans-octadecenoic acid (C18:1-trans) and trans-isomers of linoleic acid (18:2-trans), as well as long-chain polyunsaturated fatty acids (LC-PUFA), in the plasma from infants of adolescent mothers at 3 months of age, exclusively breastfed, and the relationship with the levels of the same isomers in plasma and milk of the mothers. Samples of blood and mature milk were obtained from 49 healthy adolescent mothers and their exclusively breastfed infants treated at the Instituto Fernandes Figueira-Fundação Oswaldo Cruz (IFF-FIOCRUZ) in Rio de Janeiro, Brazil. trans-Fatty acids (TFA) were analyzed by gas chromatography. The results of this study showed low levels of TFA in milk (1.53%), maternal plasma (0.50%), and plasma of infants (0.74%). The results show that, although TFA have been found in the plasma of the studied infants, the LC-PUFA levels are kept within normal limits. No association between TFA presence and parameters of nutritional status of the infants was observed, probably due to the low levels of these fatty acids found in this study.

[The importance of essential fatty acids and the effect of trans fatty acids in human milk on fetal and neonatal development]. / Importância dos ácidos graxos essenciais e os efeitos dos ácidos graxos trans do leite materno para o desenvolvimento fetal e neonatal.

Breastfeeding has a major impact on public health, since human breast milk is the best food for infants up to six months of age. The lipid fraction in human milk is the main source of energy for the infant and supplies essential nutrients such as fat-soluble vitamins and polyunsaturated fatty acids (PUFA). Essential fatty acids (EFA), specifically linoleic acid (LA, 18:2n-6) and alpha-linolenic acid (ALA, 18:3n-3), are precursors of long-chain polyunsaturated fatty acids (LC-PUFA), including docosahexaenoic (DHA) and arachidonic (ARA) acids. Quality of lipids in secreted milk is precisely related to maternal ingestion. LC-PUFAs protect against allergy and infection and are important for visual and cognitive development in infancy. Industrial food processing has introduced the trans fatty acids (TFA) among the nutrients available to the population. TFA can interfere with the metabolism of essential fatty acids by decreasing LC-PUFA synthesis. It is thus important to raise population awareness on the importance of adequate PUFA consumption and reduced TFA intake during prenatal and postnatal development.

Importância dos ácidos graxos essenciais e os efeitos dos ácidos graxos trans do leite materno para o desenvolvimento fetal e neonatal / The importance of essential fatty acids and the effect of trans fatty acids in human milk on fetal and neonatal development

A prática da amamentação tem grande impacto do ponto de vista da saúde pública, pois o leite materno é o melhor alimento a ser oferecido até o sexto mês de vida da criança. A fração lipídica do leite representa a maior fonte de energia para crianças e fornece nutrientes essenciais, tais como vitaminas lipossolúveis e ácidos graxos poliinsaturados (AGPI). Os ácidos graxos essenciais (AGE) linoléico (LA, 18:2n-6) e alfa-linolênico (ALA, 18:3n-3) são precursores dos ácidos graxos poliinsaturados de cadeia longa (AGPI-CL), incluindo os ácidos docosahexaenóico (DHA) e araquidônico (ARA). A qualidade dos lipídios no leite secretado está diretamente relacionada com a ingestão materna. Os AGPI-CL são importantes na proteção contra alergia e infecções, no processo visual e no desenvolvimento cognitivo na infância. O processamento industrial de alimentos introduziu os ácidos graxos trans (AGT) entre os nutrientes disponíveis à população. Os AGT podem interferir no metabolismo dos AGE, diminuindo a síntese de DHA e ARA. Portanto, nos parece relevante esclarecer a população sobre a importância de um aporte adequado de AGPI e reduzido de AGT durante o período de desenvolvimento pré e pós-natal.

Breastfeeding has a major impact on public health, since human breast milk is the best food for infants up to six months of age. The lipid fraction in human milk is the main source of energy for the infant and supplies essential nutrients such as fat-soluble vitamins and polyunsaturated fatty acids (PUFA). Essential fatty acids (EFA), specifically linoleic acid (LA, 18:2n-6) and alpha-linolenic acid (ALA, 18:3n-3), are precursors of long-chain polyunsaturated fatty acids (LC-PUFA), including docosahexaenoic (DHA) and arachidonic (ARA) acids. Quality of lipids in secreted milk is precisely related to maternal ingestion. LC-PUFAs protect against allergy and infection and are important for visual and cognitive development in infancy. Industrial food processing has introduced the trans fatty acids (TFA) among the nutrients available to the population. TFA can interfere with the metabolism of essential fatty acids by decreasing LC-PUFA synthesis. It is thus important to raise population awareness on the importance of adequate PUFA consumption and reduced TFA intake during prenatal and postnatal development.