Physical and mental health impact of the COVID-19 pandemic at first year in a Spanish adult cohort.

The COVID-19 pandemic and the political and health measures have profoundly affected the health of our populations. However, very few studies have been published assessing its impact using a prospective cohort. The aim of this study is to describe the impact on physical and mental health due to the COVID-19 pandemic in the general population in Spain, and according to COVID-19 clinical status, during the first year of the pandemic. A longitudinal cohort study with two online surveys were performed on a representative sample of the adult Spanish population before (N = 2005, October/November 2019) and during the pandemic (N = 1357, November/December 2020). We assessed disability using the World Health Organisation Disability Assessment Schedule (WHODAS), major depressive episode (MDE) and suicidal thoughts and behaviours (STB), using an adapted version of the Composite International Diagnostic Interview (CIDI 3.0); generalised anxiety disorder (GAD) using the GAD-7 scale; post-traumatic stress disorder (PTSD) symptoms using the PTSD checklist for DSM-5 (PCL-5). For physical health, there was a statistically significant loss of weight (mean/SD) (T0, 73.22/15.56 vs. T1, 71.21/11.94), less use of tobacco (T0, 11.4% vs. T1, 9.0%) and decreased disability (mean/SD) (T0, 21.52/9.22 vs. T1, 19.03/7.32). For mental health, there was a significant increase in MDE (T0, 6.5% vs. T1, 8.8%) and in the prevalence of GAD (T0, 13.7% vs. T1, 17.7%). The prevalence of STB (T0, 15.1% vs. T1, 7.1%) significantly decreased. Individuals who declared they had been diagnosed with COVID-19 (3.6%) showed a worsening in physical health and an increase in mental health problems and PTSD symptoms. Although suicide risk during the first year of the pandemic was significantly less, many suicide risk factors increased: such as the incidence and persistence of MDE and GAD, the presence of PTSD symptoms in those diagnosed with COVID-19, and a worsening in self-assessed health status. We expect an increase in STB in the population in the long-term. Future research should gather information about the long-term impact of the pandemic.

Medidas de frecuencia utilizadas en estudios de cohortes para evaluar el comportamiento suicida en jóvenes (12-26 años): una revisión sistemática / Measures of frequency used in cohorts studies to evaluate the suicidal behaviour in young people (12-26 years): a systematic review

Introducción: La OMS prioriza para el año 2020 reducir las tasas de suicidio señalando dificultades para dar estimaciones precisas debido a una amplia variedad de factores, entre ellos, aspectos relativos a la propia medición estadística de la conducta suicida. La proporción de muertes por suicidio es del 8,5% para los jóvenes de entre 15-29 años. Objetivo: Revisar la metodología empleada para expresar la frecuencia de la conducta suicida en población joven y describir las características metodológicas de los estudios examinados. Método: Revisión sistemática de estudios longitudinales registrada en PROSPERO. La información extraída fue: año de publicación, revista, tamaño poblacional, muestra, país, diseño, edad, porcentaje de hombres, tiempo de seguimiento y pérdidas, comportamiento suicida, factores de riesgo, aspectos éticos y evaluándose fundamentalmente las medidas de frecuencia empleadas. Resultados: Se identificaron 37.793 documentos, de los cuales fueron seleccionados 82. Ningún estudio define la medida de frecuencia empleada para la conducta suicida, encontrándose hasta 9 formas diferentes de medirla. La población son estudiantes o población general (66%), cohortes de nacimiento (16%) y colectivos específicos. El seguimiento fue de 24 semanas hasta 30 años. Solo un 24,1% de los estudios consideró los aspectos éticos. Conclusiones: Se constata que no existe una sistematización a la hora de medir la frecuencia de presentación de la conducta suicida. La variabilidad metodológica y terminológica utilizada dificulta hacer comparaciones entre los estudios y conocer la verdadera dimensión del problema. Se insta a los investigadores a realizar un esfuerzo para consensuar las medidas de frecuencia empleadas en los estudios de cohortes

Introduction: A priority for the WHO by 2020 is to have reduced the rates of suicide; they indicate difficulties in giving precise estimations due to a wide variety of factors, which include aspects related to the statistical measurements themselves of suicidal behaviour. The proportion of deaths from suicide is 8.5% among young people between 15-29 years of age. Objective: To review the methodology used to express the frequency of suicidal behaviour in young people and to describe the methodological characteristics of the studies reviewed. Method: A systematic review of longitudinal studies registered on PROSPERO. The extracted information included the following: year of publication, journal, population size, sample, country, design, age, percentage of men, follow-up time and losses, suicidal behaviour, risk factors, ethical aspects, fundamentally, evaluating the measures of frequency used. Results: Eighty-two articles were selected from 37,793 documents. None of the studies define the measure of frequency used for suicidal behaviour, there are currently up to 9 different ways of measuring it. The populations are students or the general population (66%), birth cohorts (16%) and specific groups. Follow-up was from 24 weeks to 30 years. Only 24.1% of the studies took ethical aspects into consideration. Conclusions: Researchers must make an effort to reach an agreement on the measures of frequency used in suicidal behaviour studies, as the methodological and terminological variability currently used impedes making any comparisons between different studies or understanding the real dimension of the problem

Measures of frequency used in cohorts studies to evaluate the suicidal behaviour in young people (12-26 years): A systematic review. / Medidas de frecuencia utilizadas en estudios de cohortes para evaluar el comportamiento suicida en jóvenes (12-26 años): una revisión sistemática.

INTRODUCTION: A priority for the WHO by 2020 is to have reduced the rates of suicide; they indicate difficulties in giving precise estimations due to a wide variety of factors, which include aspects related to the statistical measurements themselves of suicidal behaviour. The proportion of deaths from suicide is 8.5% among young people between 15-29 years of age. OBJECTIVE: To review the methodology used to express the frequency of suicidal behaviour in young people and to describe the methodological characteristics of the studies reviewed. METHOD: A systematic review of longitudinal studies registered on PROSPERO. The extracted information included the following: year of publication, journal, population size, sample, country, design, age, percentage of men, follow-up time and losses, suicidal behaviour, risk factors, ethical aspects, fundamentally, evaluating the measures of frequency used. RESULTS: Eighty-two articles were selected from 37,793 documents. None of the studies define the measure of frequency used for suicidal behaviour, there are currently up to 9 different ways of measuring it. The populations are students or the general population (66%), birth cohorts (16%) and specific groups. Follow-up was from 24 weeks to 30 years. Only 24.1% of the studies took ethical aspects into consideration. CONCLUSIONS: Researchers must make an effort to reach an agreement on the measures of frequency used in suicidal behaviour studies, as the methodological and terminological variability currently used impedes making any comparisons between different studies or understanding the real dimension of the problem.

Teratoma retroperitoneal toracoabdominalneonatal: abordatge transdiafragmàtic / Transdiaphragmatic Approach for a Neonatal Retroperitoneal Thoracoabdominal Teratoma

Introduction. Teratomas comprise only 3.5% of germcell tumors. We report a case of a 1-month-old girl whowas diagnosed with a large retroperitoneal thoracoabdominalteratoma.Case report. Her presenting features included an expandingabdominal girth, failure to thrive and progressiverespiratory distress. An abdomen X-Ray showed calcifications,and alpha-fetoprotein levels were moderately elevated.Additional studies included abdomen US, CT and MRI,which showed a large abdominal mass adjacent to thegreat vessels with an hour-glass shaped intrathoracic extension,and an anteriorly displaced right hydronephrotickidney. The surgical intervention was performed using acombined abdominal and transdiaphragmatic approach.Pathology showed immature teratoma.Discussion. A transdiaphragmatic surgical approachmay be very useful in scenarios where the great vessels areinvolved and the mass extends into the chest. In our case,this approach was very successful, allowing for a completeresection without resulting in phrenic paralysis. The rightkidney, which was displaced and hydronephrotic at diagnosis,has remained with low function. The patient iscurrently being followed every three months with imagingstudies and alpha-fetoprotein levels (AU)

Introducció. Els teratomes retroperitoneals representennomés el 3.5% dels tumors de cèl·lules germinals. Presentemel cas d’una lactant d’un mes de vida amb un granteratoma retroperitoneal toracoabdominal dret.Cas clínic. Lactant que ingressa al mes de vida tramesapel seu pediatre per simptomatologia de distensió abdominalprogressiva, estancament pondoestatural, posiciód’opistòtons de cap i tronc i dificultat respiratòria. La radiografiad’abdomen mostra calcificacions. Els nivells d’alfafetoproteïnavan ser moderadament elevats per l’edatde la pacient. L’ecografia, la tomografia i la ressonànciamagnètica mostraven una gran massa abdominal en relacióamb els grans vasos i una hidronefrosi dreta d’un ronyóde localització anterior amb visualització d’una imatged’elevació del diafragma interpretada com a secundària ala compressió per la tumoració. La complicada reseccióquirúrgica es va dur a terme per abordatge abdominali transdiafragmàtic perquè la tumoració tenia un doblecomponent toracoabdominal en rellotge de sorra.Comentari. L’abordatge transdiafragmàtic pot ser útilen situacions especials quan hi estan implicats els grans vasosi, a la vegada, hi ha un component toràcic. No s’ha produïtparàlisi frènica. Només el ronyó dret que tenia una alteracióen la morfologia i la localització i una hidronefrosiimportant en la intervenció, persisteix amb una baixa funció.Com que es tractava d’un teratoma immadur, cada tresmesos es controlen estrictament els nivells d’alfafetoproteïnai es repeteixen les tècniques d’imatge ecogràfiques (AU)