job tenure as a potential protective factor

Funding Information: The authors would like to thank Patricia Soares, PhD, from the Portuguese School of Public Health, Lisbon, Portugal, for her assistance in planning and reviewing the statistical analysis of the study and for her contribution to the manuscript scientific writing. Funding Information: The article processing fee has been supported by Lundbeck Portugal. Publisher Copyright: Copyright © 2022 Antao, Sacadura-Leite, Correia and Figueira.Burnout is an impactful occupational health phenomenon to which doctors and nurses have been more exposed during the COVID-19 pandemic. The objectives of this study were to measure the dimensions of burnout—emotional exhaustion, depersonalization and personal accomplishment—in a hospital healthcare population after the second COVID-19 wave and to study their association with sociodemographic variables and previous COVID-19 infection. We invited 112 healthcare professionals (doctors and nurses) who attended the occupational health department of a tertiary hospital in March–July 2021. Emotional exhaustion, depersonalization and personal accomplishment were measured by the Maslach Burnout Inventory. Linear-regression analyses were conducted to explore relationships between burnout dimensions and sociodemographic variables. Differences between groups according to previous COVID-19 infection were verified using the t-test and when appropriate the Mann–Whitney test (for continuous variables), the chi-square test and when appropriate the Fisher exact test (for categorical variables). We surveyed 106 subjects (95% response rate). High emotional exhaustion and depersonalization were reported by 33.0 and 18.4% of participants, respectively; 21.4% reported low personal accomplishment. Job tenure was associated with depersonalization and personal accomplishment. For each 1-year increase in job tenure, depersonalization decreases 0.14 (95% CI [−0.23, −0.04]) and personal accomplishment increases 0.16 (95% CI [0.06, 0.25]). Gender was associated with emotional exhaustion (being male increases emotional exhaustion 5.62-fold [95% CI: 1.33; 9.92]). The prevalence of high emotional exhaustion, high depersonalization and low personal accomplishment after the second COVID-19 wave was relevant and should not be overlooked. Our findings suggest that job tenure may play a protective role in healthcare workers’ burnout.publishersversionpublishe

CONGENITAL SYPHILIS IN THE STATE OF TOCANTINS 2007-2017: AN EPIDEMIOLOGICAL ANALYSIS

Objetivo: descrever a ocorrência da sífilis congênita no Tocantins considerando-se o perfil epidemiológico das mães e dos casos notificados no estado. Metodologia: estudo do tipo epidemiológico observacional de casos notificados de crianças com até 23 meses diagnosticadas com sífilis congênita pelo Sistema de Informação de Agravos de Notificação (Sinan) através do DATASUS TABnet para o período de 2007 a 2017. Resultados: durante esses dez anos, a incidência de sífilis congênita para o grupo pesquisado aumentou em cerca de 3,5 vezes, sendo perceptível a influência no nível de escolaridade materna bem como a realização de pré-natal e o tratamento adequado do parceiro. Conclusão: entre 2007 e 2017, o número de casos de sífilis congênita no Brasil e no estado do Tocantins, em geral, aumentou, havendo diferenças entre grupos epidemiológicos. O controle da sífilis congênita envolve medidas públicas voltadas para campanhas, melhoria nos sistemas de detecção e tratamento, além de maior controle de notificação da doença.   Palavras-chave: sífilis congênita; epidemiologia; cuidado pré-natal. ABSTRACT Objective: to describe the occurrence of congenital syphilis in Tocantins, Brazil, considering the epidemiological profile of mothers and reported cases in the State. Methodology: observational epidemiological study of reported cases of children up to 23 months old diagnosed with congenital syphilis by the Sistema de Informação de Agravos de Notificação (SINAN) through DATASUS TABnet for the period 2007 to 2017. Results: during these ten years, the incidence of congenital syphilis for the group studied increased by about 3,5 times, being perceptible the influence of mother´s level education as well as prenatal and appropriate treatment of the partner. Conclusion: between 2007 and 2017, the number of cases of congenital syphilis in Brazil and in the state of Tocantins, in general, increased, with differences between epidemiological groups. Congenital syphilis control involves public measures aimed at campaigns, improvement in detection and treatment systems, and greater control of disease notification. Keywords: congenital syphilis; epidemiology; prenatal care.Objective: to describe the occurrence of congenital syphilis in Tocantins, Brazil, considering the epidemiological profile of mothers and reported cases in the State. Methodology: observational epidemiological study of reported cases of children up to 23 months old diagnosed with congenital syphilis by the Sistema de Informação de Agravos de Notificação (SINAN) through DATASUS TABnet for the period 2007 to 2017. Results: during these ten years, the incidence of congenital syphilis for the group studied increased by about 3,5 times, being perceptible the influence of mother´s level education as well as prenatal and appropriate treatment of the partner. Conclusion: between 2007 and 2017, the number of cases of congenital syphilis in Brazil and in the state of Tocantins, in general, increased, with differences between epidemiological groups. Congenital syphilis control involves public measures aimed at campaigns, improvement in detection and treatment systems, and greater control of disease notification. Key words: congenital syphilis; epidemiology; prenatal care

The safety of agomelatine in standard medical practice in depressed patients : a 26‐week international multicentre cohort study

© 2020 The Authors. Human Psychopharmacology: Clinical and Experimental published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Objective: The present observational cohort study documented the safety of agomelatine in current medical practice in out-patients suffering from major depressive disorder. Method: The 6-month evolution of agomelatine-treated patients was assessed with a focus on safety (emergent adverse events, liver acceptability), severity of depression using the Clinical Global Impression Severity (CGI-S) score, and functioning measured by the Sheehan Disability Scale (SDS). Results: A total of 8453 depressed patients from 761 centres in 6 countries were analysed (female: 67.7%; mean age: 49.1 ± 14.8 years). Adverse events reported were in accordance with the known safety profile of agomelatine. Cutaneous events were reported in 1.7% of the patients and increased hepatic transaminases values were reported in 0.9 % of the patients. The incidence of events related to suicide/self-injury was 1.0%. Two completed suicides, not related to the study drug, were reported. CGI-S total scores and SDS sub-scores improved and numbers of days lost or underproductive decreased over the treatment period. Conclusions: In standard medical practice, agomelatine treatment was associated with a low incidence of side effects. No unexpected events were reported. A decrease in the severity of the depressive episode and improved functioning were observed.info:eu-repo/semantics/publishedVersio

Comparison with adult-onset rheumatic diseases

Objective To compare physical disability, mental health, fatigue and health-related quality of life (HRQoL) across juvenile idiopathic arthritis (JIA) categories in adulthood and between JIA and adult-onset rheumatic diseases. Methods Cross-sectional analysis nested in a cohort of adult patients with JIA registered in the Rheumatic Diseases Portuguese Register (Reuma.pt). Physical disability (Health Assessment Questionnaire - Disability Index), mental health symptoms (Hospital Anxiety and Depression Scale), fatigue (Functional Assessment of Chronic Illness Therapy - Fatigue Scale (FACIT-F)) and HRQoL (EuroQol-5D (EQ5D) and Short Form (SF-36)) were compared across JIA categories. Patients with polyarticular JIA and enthesis-related arthritis (ERA) JIA were compared respectively to patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA), matched for gender and age, adjusted for disease duration and activity. Results 585 adult patients with JIA were included. Comparison across JIA categories showed that persistent oligoarthritis and patients with ERA reported a higher score in EQ5D and SF-36 physical component when compared with other JIA categories. Polyarticular JIA reported less disability and fatigue than patients with RA (median Health Assessment Questionnaire of 0.25 vs 0.63; p<0.001 and median FACIT-F score 42 vs 40; p=0.041). Polyarticular JIA had also better scores on EQ5D and all domains of SF-36, than patients with RA. Patients with ERA reported less depression and anxiety symptoms (0% vs 14.8%; p=0.003% and 9% vs 21.3%; p=0.002) and less fatigue symptoms (45 vs 41; p=0.01) than patients with SpA. Conclusion Persistent oligoarticular JIA and ERA are the JIA categories in adulthood with better HRQoL. Overall, adult polyarticular and patients with ERA JIA have lower functional impairment and better quality-of-life than patients with RA and SpA.publishersversionpublishe

Influência da domperidona na reprodução masculina: uma revisão bibliográfica / Influence of domperidone in male reproduction: a bibliographic review

Atualmente problemas como a subfertilidade e a infertilidade tem afetado casais em cerca de 50% e 16,7%, respectivamente. Desses, a maior parte está associado à infertilidade masculina, o qual abrange cerca de 8% dos homens. Objetivou-se realizar uma revisão bibliográfica sobre a influência da domperidona na reprodução masculina. Para o estudo buscou-se referenciais relacionados ao tema abordado nas bases de dados do Google Acadêmico, Pubmed, Scielo, Lilacs e Bireme, sendo selecionados trabalhos no período de 1996 a 2020. A domperidona é um medicamento procinético bloqueador da dopamina D2 comumente utilizado para tratar distúrbios da motilidade gastrointestinal. Estudos mostraram que esse medicamento pode causar disfunções na reprodução masculina, pois seu uso causa aumento excessivo nos níveis de prolactina (PRL), observado em 50% dos casos. A PRL modula os receptores FSH e LH nas células de Sértoli e Leydig, e está envolvido na meiose de células germinativas, regulando várias funções dos testículos. O aumento nos níveis de PRL interrompe a secreção pulsátil do hormônio liberador de gonadotrofina, inibe a liberação de LH, FSH, e reduz diretamente a esteroidogênese gonadal, causando efeitos expressivos na espermatogênese, assim como afeitos clínicos como hipogonadismo hipogonadotrófico adquirido e até infertilidade. Diante do exposto, pode-se considerar que a domperidona é um possível indutor a disfunções reprodutivas no homem, devido ao seu potencial de causar desregulação no hormônio que regula as gônadas masculinas.

Clinical management and burden of bipolar disorder: a multinational longitudinal study (WAVE-bd Study)

BACKGROUND: Studies in bipolar disorder (BD) to date are limited in their ability to provide a whole-disease perspective--their scope has generally been confined to a single disease phase and/or a specific treatment. Moreover, most clinical trials have focused on the manic phase of disease, and not on depression, which is associated with the greatest disease burden. There are few longitudinal studies covering both types of patients with BD (I and II) and the whole course of the disease, regardless of patients' symptomatology. Therefore, the Wide AmbispectiVE study of the clinical management and burden of Bipolar Disorder (WAVE-bd) (NCT01062607) aims to provide reliable information on the management of patients with BD in daily clinical practice. It also seeks to determine factors influencing clinical outcomes and resource use in relation to the management of BD. METHODS: WAVE-bd is a multinational, multicentre, non-interventional, longitudinal study. Approximately 3000 patients diagnosed with BD type I or II with at least one mood event in the preceding 12 months were recruited at centres in Austria, Belgium, Brazil, France, Germany, Portugal, Romania, Turkey, Ukraine and Venezuela. Site selection methodology aimed to provide a balanced cross-section of patients cared for by different types of providers of medical aid (e.g. academic hospitals, private practices) in each country. Target recruitment percentages were derived either from scientific publications or from expert panels in each participating country. The minimum follow-up period will be 12 months, with a maximum of 27 months, taking into account the retrospective and the prospective parts of the study. Data on demographics, diagnosis, medical history, clinical management, clinical and functional outcomes (CGI-BP and FAST scales), adherence to treatment (DAI-10 scale and Medication Possession Ratio), quality of life (EQ-5D scale), healthcare resources, and caregiver burden (BAS scale) will be collected. Descriptive analysis with common statistics will be performed. DISCUSSION: This study will provide detailed descriptions of the management of BD in different countries, particularly in terms of clinical outcomes and resources used. Thus, it should provide psychiatrists with reliable and up-to-date information about those factors associated with different management patterns of BD. TRIAL REGISTRATION NO: ClinicalTrials.gov: NCT01062607