Acute Stress in Health Workers during Two Consecutive EpidemicWaves of COVID-19

The COVID-19 pandemic has provoked generalized uncertainty around the world, with health workers experiencing anxiety, depression, burnout, insomnia, and stress. Although the effects of the pandemic on mental health may change as it evolves, the majority of reports have been web-based, cross-sectional studies. We performed a study assessing acute stress in frontline healthworkers during two consecutive epidemic waves. After screening for trait anxiety/depression and dissociative experiences, we evaluated changes in acute stress, considering resilience, state anxiety, burnout, depersonalization/derealization symptoms, and quality of sleep as cofactors. During the first epidemic wave (April 2020), health workers reported acute stress related to COVID-19, which was related to state anxiety. After the first epidemic wave, acute stress decreased, with no increase during the second epidemic wave (December 2020), and further decreased when vaccination started.During the follow-up (April 2020 to February 2021), the acute stress score was related to bad quality of sleep. However, acute stress, state anxiety, and burnout were all related to trait anxiety/depression, while the resilience score was invariant through time. Overall, the results emphasize the relevance of mental health screening before, during

DM GAIT 2019 1

ANTHROPOMETRY & GAI

Individual Cofactors and Multisensory Contributions to the Postural Sway of Adults with Diabetes

To assess the interactions between individual cofactors and multisensory inputs on the postural sway of adults with type 2 diabetes and healthy subjects, 69 adults accepted to participate in the study (48 with/21 without diabetes). Assessments included neuro-otology (sinusoidal-rotation and unilateral-centrifugation), ophthalmology and physiatry evaluations, body mass index (BMI), physical activity, quadriceps strength, the ankle/brachial index and polypharmacy. Postural sway was recorded on hard/soft surface, either with eyes open/closed, or without/with 30° neck extension. The proportional differences from the baseline of each condition were analyzed using Multivariate and Multivariable analyses. Patients with polyneuropathy and no retinopathy showed visual dependence, while those with polyneuropathy and retinopathy showed adaptation. Across sensory challenges, the vestibulo-ocular gain at 1.28 Hz and the BMI were mainly related to changes in sway area, while the dynamic visual vertical was mainly related to changes in sway length. The ankle/brachial index was related to the effect of neck extension, with contributions from quadriceps strength/physical activity, polyneuropathy and polypharmacy. Across conditions, men showed less sway than women did. In conclusion, in adults with diabetes, sensory inputs and individual cofactors differently contribute to postural stability according to context. Rehabilitation programs for adults with diabetes may require an individualized approach

Influence of Tobacco Smoke Exposure on the Protein Expression of α7 and α4 Nicotinic Acetylcholine Receptors in Squamous Cell Carcinoma Tumors of the Upper Aerodigestive Tract (Out of the Larynx)

Purpose: To assess protein expression of α7 and α4 nicotinic acetylcholine receptors (nAChR) subtypes in squamous cell carcinoma of the upper aerodigestive track (out of the larynx) according to tobacco smoke exposure, considering the general characteristics of the patients. Methods: The α7 and α4 nAChR subtypes were assessed by immunohistochemistry in tumor samples from 33 patients with novel diagnosis of squamous cell carcinoma of the upper aerodigestive tract (out of the larynx). Results: Current smokers were middle-age men with alcohol consumption, whereas elderly women with no alcohol consumption prevailed among nonsmokers. Expression of α4 nAChR was high in all groups, with an influence of alcohol use, although expression of α7 nAChR was low in current smokers with alcohol use. Expression of α4 with no expression of α7 nAChR was associated with advanced disease. Conclusions: Squamous cell carcinoma tumors of the upper aerodigestive tract (out of the larynx) may show desensitization of α4 nAChR. Advanced disease at diagnosis might be associated with desensitization of α4 with decrease in α7 nAChR

Effect of cigarette smoke on counts of immunoreactive cells to eotaxin-1 and eosinophils on the nasal mucosa in young patients with perennial allergic rhinitis

Abstract Introduction: In teenagers with perennial allergic rhinitis, exposure to tobacco cigarette smoke increases the count of eosinophils in the nasal mucosa; the recruitment of eosinophils arises from the combined action of a number of cellular and molecular signals, including eotaxin. Objective: To assess the effect of exposure to tobacco cigarette smoke on the count of immunoreactive cells to eotaxin-1 and eosinophils on the nasal mucosa of children and teenagers with perennial allergic rhinitis. Methods: In a cross-sectional study, forty-four patients were evaluated (aged 7-19 years old): 22 with and 22 with no exposure to tobacco cigarette smoke. After replying to 2 validated questionnaires, on Asthma and Allergies in Childhood and on the severity of nasal symptoms, nasal mucosal samples were obtained by scraping the middle one-third of the inferior turbinates. Then counts of immunoreactive cells to eotaxin-1 and eosinophils were assessed by immunohistochemistry. Results: Patients with exposure to tobacco cigarette smoke showed higher cell counts of both eotaxin-1 and eosinophils than patients with no exposure to the smoke, with no correlation between the two variables. However, both counts, of eotaxin-1 and eosinophils, were related to the cotinine/creatinine ratio. Conclusions: Exposure to tobacco cigarette smoke can increase eotaxin-1 and the count of eosinophils in the nasal mucosa of young patients with perennial allergic rhinitis