Analyzing the Impact of COVID-19 Trauma on Developing Post-Traumatic Stress Disorder among Emergency Medical Workers in Spain

Producción CientíficaThe early stages of the COVID-19 pandemic presented the characteristics of a traumatic event that could trigger post-traumatic stress disorder. Emergency Medical Services workers are already a high-risk group due to their professional development. The research project aimed to analyse the impact of the COVID-19 pandemic on EMS professionals in terms of their mental health. For this purpose, we present a descriptive crosssectional study with survey methodology. A total of 317 EMS workers (doctors, nurses, and emergency medical technicians) were recruited voluntarily. Psychological distress, post-traumatic stress disorder, and insomnia were assessed. The instruments were the General Health Questionnaire-12 (GHQ-12), the Davidson Trauma Scale (DTS-8), and the Athens Insomnia Scale (AIS-8). We found that 36% of respondents had psychological distress, 30.9% potentially had PTSD, and 60.9% experienced insomnia. Years of work experience were found to be positively correlated, albeit with low effect, with the PTSD score (r = 0.133). Finally, it can be stated that the COVID-19 pandemic has been a traumatic event for EMS workers. The number of professionals presenting psychological distress, possible PTSD, or insomnia increased dramatically during the early phases of the pandemic. This study highlights the need for mental health disorder prevention programmes for EMS workers in the face of a pandemic.Departamento de Enfermería de la Universidad de Valladoli

Los yacimientos de vertebrados del Mioceno medio de Somosaguas (Pozuelo de Alarcón, Madrid): implicaciones paleoambientales y paleoclimáticas

The Middle Miocene vertebrate fossil sites from the Somosaguas Campus of the Complutensian University of Madrid (Pozuelo de Alarcón) have provided many fossils from 23 mammal species, dated in local zone E (MN5, Middle Aragonian). In this work we show new research results which allow recognizing a new species of rhinoceros for the Madrid Basin (Prosantorhinus douvillei) and defining a new species of hamster (Cricetodon soriae nov. sp.). The succession shows several episodes of debris-flow deposits transporting bones, pebbles and arkosic sands, discordant below and above lacustrine sediments. The deposits contain an alteration sequence of micas, with neomorphic clays progressively more evolved and caliche lining on top, wich indicate increasing aridity. The richness of the Somosaguas fossil association allows us to relate this site with other assemblages of similar age, which gives a biogeographical pattern close to the palaearctic-palaeotropical transition associations. This is coincident with the palaeoclimatic data provided by the mammalian association, which indicates the presence of tropical conditions with strong hydric seasonality. A mosaic of environments integrated within a savanna biome is inferred in the area, combining open areas and small woodlands associated to a lacustrine environment. The isotopic analyses indicate a progressive cooling and drying trend, which correlates with the inferred global climatic changes in this period around 14 million years ago.Los yacimientos de vertebrados del Mioceno medio del Campus de Somosaguas de la Universidad Complutense de Madrid (Pozuelo de Alarcón) han proporcionado numerosos restos pertenecientes a 23 especies de mamíferos datados en la zona local E (MN5, Aragoniense Medio). En este trabajo se presentan nuevas aportaciones a su estudio, que han permitido descubrir una especie de rinoceronte no citada anteriormente en la cuenca de Madrid (Prosantorhinus douvillei) y la definición de una especie nueva de hámster (Cricetodon soriae nov. sp.). La sucesión muestra varios episodios de coladas de tipo debris-flow con transporte de huesos, rocas y arcosas discordantes por debajo y por encima de un relleno lacustre. Los depósitos contienen una secuencia de alteración de micas con arcillas de neoformación progresivamente más evolucionadas y vetas de caliche hacia techo, indicando aridez creciente. La riqueza del conjunto de macro y microvertebrados de los yacimientos de Somosaguas permite relacionarlo con el de otros yacimientos de edad similar, resultando en un patrón biogeográfico de transición paleártico-paleotropical. Esto coincide con los datos paleoclimáticos aportados por la fauna de mamíferos, que indican la existencia de condiciones tropicales con estacionalidad hídrica muy marcada. Se infiere la existencia en el área de un mosaico de ambientes dentro de un bioma de sabana, combinando áreas abiertas y bosquetes asociados al medio lacustre. El análisis isotópico indica un progresivo enfriamiento y aridez, que se correlaciona con los cambios climáticos inferidos a escala global en este período, hace unos 14 millones de años.La Universidad Complutense de Madrid (UCM), la Comunidad Autónoma de Madrid (CAM) y el Ministerio de Ciencia y Tecnología (MCYT) han proporcionado financiación para la realización de las excavaciones a lo largo del último lustro (AE00-0256-DIF). La realización de este trabajo se enmarca dentro de los proyectos BTE2002-1430, BTE2003-03001, CGL2004-02094/BTE, CGL2005-03900/BTE, CGL2006-01773/BTE y CGL2006-04646/BTE del Ministerio de Educación y Ciencia y PR1/06-14470-B de la Universidad Complutense de Madrid. La UCM y la CAM concedieron ayudas a los grupos de investigación UCM-CAM 910161 sobre Registro Geológico de Períodos Críticos: Factores Paleoclimáticos y Paleoambientales y UCM-CAM 910607 sobre Evolución de Mamíferos y Paleoambientes Continentales Cenozoicos. M.H.F. disfruta de un contrato UCM del Programa «Ramón y Cajal» del Ministerio de Educación y Ciencia. M.J.S. disfruta de un contrato CSIC del Programa «Juan de la Cierva» del Ministerio de Educación y Ciencia.Peer reviewe

FOXP3 and TGF-β: Differential Regulatory Molecules between Sensitization and Tolerance to Olive Pollen

Different molecular mechanisms may modulate sensitization and natural or induced tolerance to allergens. We have searched for differential mechanisms at humoral and cellular level in the olive pollen allergic response, checking the influence of exposure to allergens of subjects from an area with extremely high antigenic load during the pollen season. Sera and PBMCs were obtained during and outside the pollen season. Distinct Ig subtypes (total IgE and specific IgE, IgG4 and IgA), and Th1, Th2 and regulatory T cells (Treg) cytokines were analyzed in 5 groups of subjects: Group 1, non-allergic; Group 2, asymptomatic, sensitized to olive pollen; Group 3, allergic to pollen other than olive; Group 4, allergic to olive pollen (not treated); and Group 5, allergic to olive pollen, and getting specific immunotherapy. Asymptomatic subjects showed the highest total IgE levels. The major difference found between untreated and treated subjects was the high levels of non-inflammatory antibodies (IgG4) in treated Patients. The main result of cytokine analyses was the statistically significant decrease in TGF-β levels in untreated olive pollen allergic subjects (pollen season) compared with treated. A significant decrease in forkhead winged-helix transcription factor (FOXP3) mRNA expression (marker of regulatory response) and a lower presence of Treg cells in PBMCs of olive pollen allergic subjects was found. The results Point to a decrease in the cellular regulatory mechanisms mediated by TGF-β and FOXP3 in olive-pollen allergic patients that could be restored after specific-immunotherapy

Metotrexato en artritis idiopática juvenil: efectos adversos y factores asociados

Introducción: El metotrexato (MTX) es el fármaco sistémico más utilizado en el tratamiento de pacientes con artritis idiopática juvenil. Su efectividad viene limitada por el desarrollo de efectos adversos (EA). Pacientes y métodos: Estudio observacional descriptivo retrospectivo de la frecuencia y tipo de EA asociados a MTX en pacientes con artritis idiopática juvenil seguidos en un hospital terciario en el periodo 2008-2016. Resultados: Se estudió a 107 pacientes, 71/107 mujeres (66,3%) con edad al diagnóstico de 6,4 anos ˜ (RIC 3,1-12,4) durante una mediana de seguimiento de 45,7 meses (RIC 28,8-92,4). El 44,9% (48 pacientes) tenía oligoartritis y el 24,3% (n = 26) poliartritis factor-reumatoide negativo. El 48,6% (52/107) desarrolló EA, siendo los más frecuentes los síntomas gastrointestinales y los trastornos conductuales (35,6% cada uno). La edad mayor de 6 anos ˜ al inicio del tratamiento aumentaba el riesgo de desarrollar EA, tanto en el estudio univariable (OR=3,5; IC95% 1,5-7,3) como en el multivariable (aumento del riesgo del 12% por ano). ˜ La dosis, vía de administración o forma clínica no presentaban relación con el desarrollo de EA. Veinte ninos ˜ precisaron cambio de dosis o vía de administración, resolviéndose el EA en 11 (55%). MTX se suspendió en 37/107 pacientes (34,6%) por EA, principalmente por hipertransaminasemia (n = 14; 37,8%), síntomas gastrointestinales (n = 9; 24,3%) y trastornos conductuales (n = 6; 16,3%). Conclusiones: MTX es el tratamiento de elección de ninos ˜ con artritis idiopática juvenil pero produce EA en prácticamente el 50% de los pacientes. Aunque estos EA no son graves, obligan a interrumpir el tratamiento en el 35%.Introduction: Methotrexate (MTX) is the drug of choice for juvenile idiopathic arthritis. Its clinical efficacy is limited due to the development of adverse effects (AEs). Patients and methods: A retrospective observational study was conducted on the AEs associated with MTX therapy in children diagnosed with juvenile idiopathic arthritis followed-up in a tertiary hospital between 2008 and 2016. Results: The study included a total of 107 patients, of whom 71 (66.3%) were girls (66.3%). The median age at diagnosis was 6.4 years (IQR 3.1-12.4), with a median follow-up of 45.7 months (IQR 28.8-92.4). There were 48 patients (44.9%) with oligoarthritis, and 26 children (24.3%) with rheumatoid-factor negative polyarthritis. Of these, 52/107 (48.6%) developed AEs, with the most frequent being gastrointestinal symptoms (35.6%) and behavioural problems (35.6%). An age older than 6 years at the beginning of therapy increased the risk of developing AEs, both in the univariate (OR=3.5; 95% CI: 1.5-7.3) and multivariate (12% increase per year) analyses. The doses used, administration route, or International League of Associations for Rheumatology (ILAR) classification, were not associated with the development of AEs. Twenty children required a dosage or route of administration modification, which resolved the AE in 11 (55%) cases. MTX was interrupted due to the development of AEs in 37/107 patients (34.6%), mainly due to increased plasma transaminases (n = 14, 37.8%), gastrointestinal symptoms (n = 9, 24.3%) and behavioural problems (n = 6, 16.3%). Conclusions: MTX is the therapy of choice for patients with juvenile idiopathic arthritis, but 50% of the children develop some form of AE. Although the AEs are not severe, they lead to interruption of therapy in 35% of the children

Metotrexato en artritis idiopática juvenil: efectos adversos y factores asociados

Introducción: El metotrexato (MTX) es el fármaco sistémico más utilizado en el tratamiento de pacientes con artritis idiopática juvenil. Su efectividad viene limitada por el desarrollo de efectos adversos (EA). Pacientes y métodos: Estudio observacional descriptivo retrospectivo de la frecuencia y tipo de EA asociados a MTX en pacientes con artritis idiopática juvenil seguidos en un hospital terciario en el periodo 2008-2016. Resultados: Se estudió a 107 pacientes, 71/107 mujeres (66,3%) con edad al diagnóstico de 6,4 anos ˜ (RIC 3,1-12,4) durante una mediana de seguimiento de 45,7 meses (RIC 28,8-92,4). El 44,9% (48 pacientes) tenía oligoartritis y el 24,3% (n = 26) poliartritis factor-reumatoide negativo. El 48,6% (52/107) desarrolló EA, siendo los más frecuentes los síntomas gastrointestinales y los trastornos conductuales (35,6% cada uno). La edad mayor de 6 anos ˜ al inicio del tratamiento aumentaba el riesgo de desarrollar EA, tanto en el estudio univariable (OR=3,5; IC95% 1,5-7,3) como en el multivariable (aumento del riesgo del 12% por ano). ˜ La dosis, vía de administración o forma clínica no presentaban relación con el desarrollo de EA. Veinte ninos ˜ precisaron cambio de dosis o vía de administración, resolviéndose el EA en 11 (55%). MTX se suspendió en 37/107 pacientes (34,6%) por EA, principalmente por hipertransaminasemia (n = 14; 37,8%), síntomas gastrointestinales (n = 9; 24,3%) y trastornos conductuales (n = 6; 16,3%). Conclusiones: MTX es el tratamiento de elección de ninos ˜ con artritis idiopática juvenil pero produce EA en prácticamente el 50% de los pacientes. Aunque estos EA no son graves, obligan a interrumpir el tratamiento en el 35%.Introduction: Methotrexate (MTX) is the drug of choice for juvenile idiopathic arthritis. Its clinical efficacy is limited due to the development of adverse effects (AEs). Patients and methods: A retrospective observational study was conducted on the AEs associated with MTX therapy in children diagnosed with juvenile idiopathic arthritis followed-up in a tertiary hospital between 2008 and 2016. Results: The study included a total of 107 patients, of whom 71 (66.3%) were girls (66.3%). The median age at diagnosis was 6.4 years (IQR 3.1-12.4), with a median follow-up of 45.7 months (IQR 28.8-92.4). There were 48 patients (44.9%) with oligoarthritis, and 26 children (24.3%) with rheumatoid-factor negative polyarthritis. Of these, 52/107 (48.6%) developed AEs, with the most frequent being gastrointestinal symptoms (35.6%) and behavioural problems (35.6%). An age older than 6 years at the beginning of therapy increased the risk of developing AEs, both in the univariate (OR=3.5; 95% CI: 1.5-7.3) and multivariate (12% increase per year) analyses. The doses used, administration route, or International League of Associations for Rheumatology (ILAR) classification, were not associated with the development of AEs. Twenty children required a dosage or route of administration modification, which resolved the AE in 11 (55%) cases. MTX was interrupted due to the development of AEs in 37/107 patients (34.6%), mainly due to increased plasma transaminases (n = 14, 37.8%), gastrointestinal symptoms (n = 9, 24.3%) and behavioural problems (n = 6, 16.3%). Conclusions: MTX is the therapy of choice for patients with juvenile idiopathic arthritis, but 50% of the children develop some form of AE. Although the AEs are not severe, they lead to interruption of therapy in 35% of the children