The Coronavirus pandemic (Covid-19) was first identified in December 2019 in the city of Wuhan, China, and later caused a severe health crisis, causing massive disruptions to most healthcare systems ...worldwide. The Covid-19 health emergency has seen healthcare workers in the front line facing all the difficulties related to the care burden. One of the most significant and probably underinvestigated aspects is the psychological stress of the healthcare staff managing the emergency. The aim of the paper is to analyze the literature on the impact of the Covid-19 crisis on the psychological well-being of health professionals.
We conducted a systematic review of articles published on this topic during the months from January 2020 to December 2020, searching on Pub Med, Scopus and Web of Science databases.
Most of the issues can be summarized into five conceptual categories: Stress, Depression and Infection Anxiety, Anguish, Insomnia, Post Traumatic Stress Disorder, and Suicide. The literature identifies many factors contributing to the onset of anxiety, depression, and stress, like the fear of contracting the disease and transmitting it to family members and friends, stressful shifts, and little rest among several others. The literature highlights the needs for adequate measures, including proper psychological support.
The conducted review suggests that the behaviours of healthcare professionals during the emergency phase of the Covid-19 pandemic show psychological disorders that can compromise mental health. Therefore, there is a call for those in chief like hospital managers and policymakers to take action, promoting measures like surveillance, monitoring, and psychological support among others, to increase the resilience of healthcare workers, limiting stress and anxiety and allowing them to keep their performance at work.
Re-irradiation of pelvic recurrent gynecological cancer is a challenge due to the proximity of high-radiation-sensitive organs, such as the bowel and the urinary tract. Hadrontherapy for ...re-irradiation emerges as a safe and effective treatment with a mild rate of morbidity of surrounding normal tissue. To improve the dose to the tumor, a prophylactic displacement of organs at risk is needed, and a multidisciplinary approach is recommended. In this technical note, we report a surgical technique of omentum spacer placement for patients enrolled for carbon ion radiotherapy as re-irradiation for recurrent gynecological tumors.
La ré-irradiation de récidives pelviennes de cancers gynécologiques est particulièrement délicate en raison de la proximité d’organes hautement radiosensibles, comme l’intestin ou les voies urinaires. Dans ce contexte de ré-irradiation, l’hadronthérapie semble être un traitement sûr et efficace, avec un taux réduit de complications au niveau des tissus sains environnants. Afin d’optimiser la dose délivrée à la tumeur, un déplacement prophylactique des organes-à-risque peut être nécessaire et une approche multidisciplinaire est alors recommandée. Dans cette note technique, nous décrivons une technique chirurgicale pour mettre en place un espaceur à base d’épiploon pour des patientes traitées par ions carbone dans un contexte de ré-irradiation de tumeurs gynécologiques récidivantes.
Abstract Mesenchymal stem cells (MSC) are multipotent cells that differentiate into various mature cell lineages. MSC show immunomodulatory effects by inhibiting T-cell proliferation. We evaluated ...the effect of the infusion of MSC in rats experimental kidney transplantation. Sprague-Dawley transgenic rats (SD) able to express the green fluorescent protein (EGFP) were used as MSC donors. Syngeneic (Lewis to Lewis, n = 10) and allogeneic (Fischer to Lewis, n = 10) kidney transplantations were performed after bilateral nephrectomy. Five transplanted rats who received syngeneic grafts, were treated with 3 × 106 MSC (Gr B), while the other 5 did not received MSC (Gr A). Five rats with allogenic grafts received 3 × 106 MSC (Gr C) and another 5 did not receive MSC (Gr D). The MSC were infused directly into the renal artery of the graft. No immunosuppressive therapy was provided. The animals were killed after 7 days. Biochemical analysis for renal function, histological (Banff criteria) and immunohistological analysis (ED1+ and CD8+) were performed on treated animals. MSC improved kidney function in Gr B and D vs Gr A and C. The tubular damage appeared to be less severe among Gr B and Gr D with respect to Gr A and C ( P < .01). Vasculitis was more accentuated in Gr A and C ( P < .01). MSCs reduced the inflammatory infiltrate; in Gr B and D, the number of ED1+ cells was lower than in Gr A and C ( P < .005), which was also observed for CD8+ cells ( P < .05). Our study demonstrated that the infusion of MSC attenuated histological damage from acute rejection by reducing the cellular infiltration.
Abstract Ischemia reperfusion injury (IRI) is a major field of study in small bowel transplantation because of its implications regarding intestinal immunity. In this study, we have introduced some ...variations to the described models of IRI in pigs to make possible a complete isolation of the small bowel for IRI studies. In swine, two anatomical barriers make impossible a complete isolation of the small bowel at the origin of superior mesenteric artery (SMA) and vein (SMV): the main colic vessels, which originate distally to form SMA and SMV, and the blood supply of the distal portion of the duodenum and the cephalic part of the pancreas. In a group of Large White pigs (n = 5), we have performed a complete isolation of the small bowel, including sub-total colectomy and pancreaticoduodenectomy. Both SMA and SMV were isolated at the origin from the aorta and at the junction of the splenic vein, respectively. Intestinal continuity was restored with duodenojejunal anastomosis and with ileotransverse colon anastomosis. One pig died on postoperative day 5 from intestinal occlusion due to adhesions. The remaining four pigs were killed on postoperative day 7 after an uneventful postoperative course. No complications were found at autopsy. In swine, resection of part of the pancreas and duodenum and removal of the large bowel does not affect short-term survival, allowing a full isolation of the entire small bowel mimicking the transplantation procedure. Thus, this model appears to be attractive for IRI studies in the field of intestinal transplantation.
PDF
