Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Vitamin D and cathelicidin assessment in infection-induced asthma in Egyptian children

Abstract Introduction Vitamin D deficiency was hypothesized to increase the risk of respiratory infections and asthma exacerbation through a reduced production of cathelicidin, a multifunctional anti-microbial peptide essential for normal immune responses to infections. Aims Evaluation of vitamin D status and its impact upon cathelicidin in children with infection-induced asthma through assessment of their serum levels. Patients and methods The study included 65 infection-induced asthmatic children aged 9.32 ± 2.35 years (33 in exacerbation and 32 severity matched in remission) and 25 healthy controls. All children were subjected to history taking, physical examination, pulmonary function tests, CBC, and assessment of serum levels of vitamin D (25(OH)D) and cathelicidin using ELISA. Results All asthmatics and controls were deficient in vitamin D (≤ 20 ng/ml), and no significant difference was found between controls (10.77 ± 5.6 ng/ml), remission group (9.8 ± 4.89 ng/ml), and exacerbation group (8.49 ± 5 ng/ml), p = 0.29. Cathelicidin was higher in the control group (7.69 ± 4.3 ng/ml) compared to that in the remission ones (6.88 ± 3.66 ng/ml), but not significant, while it was significantly higher in the exacerbation group (9.78 ± 3.03 ng/ml) compared to that in the remission ones (p = 0.01). No significant difference between the three groups regarding percentage having vitamin D level < 10 ng/ml (p = 0.3). There was no correlation between serum cathelicidin and vitamin D levels in either asthmatics or controls. Both levels had no correlation with spirometry indices and no relation to frequency of exacerbations. Conclusion Vitamin D deficiency cannot explain infection-induced asthma. Cathelicidin elevation in exacerbations seems to be independent of vitamin D