Prevalence and associated factors of mental health outcomes among healthcare workers in Northern Colombia: A cross-sectional and multi-centre study.

Background: Mental health outcomes in Healthcare Workers (HCWs) has been few evaluated during COVID-19 pandemic in low-and middle-income countries. Our aim was carry-out a study to identify the prevalence of stress, anxiety, depressive symptoms in HCWs and associated factors to severe illness in a northern region in Colombia. Method: A cross-sectional, hospital-based survey was conducted to assess mental health outcomes in 1,149 HCWs in Colombia. The study used Perceived Stress Scale (PSS-10), 7-item Generalized Anxiety Disorder (GAD-7), and 9-item Patient Health Questionnaire (PHQ-9) to evaluate stress, anxiety, and depression symptoms, respectively. Results: 682 HCWs completed the questionnaire. The 58,21% (397/682) were nurses, 31,23% were physicians (213/682), and 10,56% (72/682) were other health professionals. The proportion of HCWs with stress, anxiety, and depressive symptoms were 59,97%, 44,87%, and 23,02%, respectively. HCWs in emergency room and Intensive Care Units (ICU) have 2-3-fold increase risk to have severe symptoms of stress. Staff in ICU have 64% more likely to have severe anxiety symptoms, and 97% more likely to have severe depression symptoms. Limitations: Including HCWs only in the northern region in Colombia; a non-probabilistic sample, and a cross-sectional design to identify causality. Conclusion: A higher proportion on mental health outcomes has been reported in HCWs in Colombia. There are work areas related with severe mental symptoms such as ICU and emergency room. Hospitals and patient-care institutions in Latin-America needs consider the mental and physical health of HCWs during outbreaks and identify health staff at-risk to implementing support strategies to mitigate adverse mental outcomes.

Cognitive deficits in adult patients with high-grade glioma: A systematic review.

INTRODUCTION: High-grade gliomas cause cognitive impairment in those who suffer from them. However, there is a lack of precise data describing the cognitive deficit that occurs in this population, which would allow to better focus neuropsychological evaluations and make better clinical decisions in favor of the patient's recovery and quality of life. For this purpose, a systematic review of the literature was carried out to search for studies on neurocognitive alterations in patients with malignant brain tumors. MATERIALS AND METHODS: The systematic review was conducted under the criteria of the PRISMA guideline for reporting systematic review and meta-analysis reports, with a search of the PubMed database (MEDLINE). Descriptive and analytical observational studies between 2015 and 2020 were considered. RESULTS: 506 articles were identified, of which 16 met the inclusion criteria and were selected in the qualitative synthesis and described in the manuscript. CONCLUSIONS: High-grade gliomas cause significant alterations in cognitive domains such as language, attention, memory, empathy and executive functions. However, more studies focused on describing the neuropsychological alterations in this population are needed in order to make better clinical treatment and rehabilitation decisions.

Post-traumatic stress disorder, anxiety, and depression symptoms in healthcare workers during COVID-19 pandemic in Colombia.

Background: Mental health outcomes in healthcare workers (HCWs) in low- and middle-income countries (LMICs) have been poorly explored during COVID-19 pandemic. Our aim was to carry out a cross-sectional study of the prevalence of mental health symptoms in HCWs in Colombia. Methods: A cross-sectional web-survey study was performed during the COVID-19 pandemic mid-2021 including HCWs in two hospitals in Colombia. The PCL-5, GAD-7, and PHQ-9 scales were used to assess the prevalence of symptoms and severity of PTSD, anxiety, and depression in Colombia. Results: From 257 surveyed respondents, 44.36% were nurses, 36.58% physicians and 19.07% other health professionals. The prevalence of PTSD, anxiety, and depressive symptoms were 18.68%, 43.19%, and 26.85%, amongst HCWs. The regression model evidence a strong risk of PTSD, anxiety, and depressive symptoms in HCWs in Colombia during the second wave of COVID-19 in the middle of 2021. Conclusions: The prevalence for several mental health symptoms in HCWs in Colombia were higher compared with the general population. HCWs are at-risk population to develop chronic symptoms and mental disorders during and after outbreaks. These results will be helpful to tailor strategies to support the physical and mental health of the HCWs in LMICs.

Concomitant Guillain-Barre syndrome with COVID-19: a case report.

BACKGROUND: During the Coronavirus disease 2019 (COVID-19) pandemic, different neurological manifestations have been observed. However, only a few cases of Guillain-Barre syndrome (GBS) and COVID-19 have been reported. Therefore, the aim of this study is to investigate a case of concomitant GBS with COVID-19 in Colombia. CASE PRESENTATION: A 39-year-old woman was admitted to a teaching hospital in Barranquilla, Colombia with a history of progressive general weakness with lower limb dominance. Previous symptoms such as ageusia, anosmia and intense headache were reported. Upon admission, facial diplegia, quadriparesis with lower extremity predominance and Medical Research Council muscular strength of 2/5 in the lower limbs and 4/5 in the upper limbs were reported. During clinical evolution, due to general areflexia, hypertensive emergency and progressive diaphragmatic weakness, the patient was admitted to an intensive care unit. The cerebrospinal fluid analysis showed protein-cytological dissociation and the GBS diagnosis was confirmed via a nerve conduction and electromyography test. With regard to the symptoms before hospitalisation, SARS-CoV-2 diagnostic testing was performed with positive results in the second test. The patient was managed with supportive care and was discharged after 20 days of hospitalization with clinical improvement. CONCLUSIONS: Only a few cases of COVID-19 with GBS have been reported. Different subtypes have been previously identified, such as Miller-Fisher syndrome and dysautonomic GBS with SARS-CoV-2 infection. This study investigated the first confirmed case of COVID-19 with concomitant GBS in Colombia. In patients with GBS, several viral and bacterial pathogens have been found in case-control studies but the factors that induce the immune-mediated destruction of the nerve tissues have not been determined. Further studies are needed to determine the possible association between COVID-19 exposure and GBS.

Avances genéticos en el trastorno por estrés postraumático / Genetic Advances in Post-traumatic Stress Disorder

RESUMEN El trastorno por estrés postraumático (TEPT) es una condición que afecta a un subgrupo de individuos que han sufrido un evento traumático con la capacidad de generar cambios psicológicos y conductuales. Estos cambios interfieren el entorno personal, familiar y social de los individuos. Diferentes genes se han identificado como marcadores de riesgo de esta enfermedad; sin embargo, la heterogeneidad poblacional y las diferencias individuales (genéticas y ambientales) han hecho difícil la identificación de marcadores genéticos válidos en los estudios realizados. Por tal motivo, han cobrado gran importancia en las últimas dos décadas los estudios de relación entre gen y ambiente con la intención de identificar fenotipos propios de la enfermedad. Se han estudiado ampliamente genes como SLC64A, FKBP5 y ADCYAP1R1, entre otros. Poco se conoce de su interacción con las vías y los circuitos moleculares y neuronales que subyacen al TEPT, pero su identificación y asociación con estímulos y ambientes específicos condicionantes de la aparición del TEPT los hacen centro de interés para el estudio de identificación de variables genómicas en TEPT. A su vez, las modificaciones epigenéticas que regulan la expresión de genes vinculados en el eje hipotálamo-pituitario-adrenal y en el circuito amígdala-corteza prefrontal media-hipocampo son de gran interés para la identificación de biomarcadores y endofenotipos en TEPT. En esta revisión se podrá elucidar los avances en genética y epigenética que han acontecido en la comprensión genómica del TEPT.

ABSTRACT Post-traumatic stress disorder, or PTSD, is a condition that affects a subgroup of individuals that have suffered a previous traumatic event capable of generating changes at a psychological and behavioural level. These changes affect the personal, family, and social environment of those who suffer from this condition. Different genes have been identified as risk markers for development of this disorder. The population heterogeneity and individual differences (genetic and environmental) of each subject have made it difficult to identify valid markers in previous studies. For this reason, studies of Gene x Environment (G x E) have gathered importance in the last two decades, with the aim of identifying of the phenotypes of a particular disease. These studies have included genes such as SLC64A, FKBP5, and ADCYAP1R1, among others. Little is known about the interaction between the genes, pathways, and the molecular and neural circuitry that underlie PTSD. However their identification and association with stimuli and specific environments that stimulate the development of PTSD makes it focus of interest for identify genomic variations in this disorder. In turn, the epigenetic modifications that regulate the expression of genes involved in the hypothalamic-pituitary-adrenal (HPA) axis and the amygdala- hippocampal-medial prefrontal cortex circuits play a role in the identification of biomarkers and endophenotypes in PTSD. In this review, the advances in genetic and epigenetic that have occurred in the genomic era in PTSD are presented.

Genetic Advances in Post-traumatic Stress Disorder. / Avances genéticos en el trastorno por estrés postraumático.

Post-traumatic stress disorder, or PTSD, is a condition that affects a subgroup of individuals that have suffered a previous traumatic event capable of generating changes at a psychological and behavioural level. These changes affect the personal, family, and social environment of those who suffer from this condition. Different genes have been identified as risk markers for development of this disorder. The population heterogeneity and individual differences (genetic and environmental) of each subject have made it difficult to identify valid markers in previous studies. For this reason, studies of Gene x Environment (G×E) have gathered importance in the last two decades, with the aim of identifying of the phenotypes of a particular disease. These studies have included genes such as SLC64A, FKBP5, and ADCYAP1R1, among others. Little is known about the interaction between the genes, pathways, and the molecular and neural circuitry that underlie PTSD. However their identification and association with stimuli and specific environments that stimulate the development of PTSD makes it focus of interest for identify genomic variations in this disorder. In turn, the epigenetic modifications that regulate the expression of genes involved in the hypothalamic-pituitary-adrenal (HPA) axis and the amygdala- hippocampal-medial prefrontal cortex circuits play a role in the identification of biomarkers and endophenotypes in PTSD. In this review, the advances in genetic and epigenetic that have occurred in the genomic era in PTSD are presented.