Association of PM2.5 and its Components with Lengths of Hospital Stay for Hand Foot and Mouth Disease in Children

Background Hand foot and mouth disease (HFMD) is a public health concern. Studies on air pollution and the lengths of hospital stay (LOS) of HFMD are scarce. Methods We characterized the clinic demographic features of 5135 hospitalized HFMD in Nanjing, China from 2012 to 2017, and analyzed the association between short-term exposure to PM2.5 as well as its components (OM, BC, SO42−, NH4+, NIT, SOIL and SS) and the LOS of HFMD. Results Among them 98.62% were aged 0–6 years old, and 3772 (73.46%) were hospitalized for seven days or less. The LOS of HFMD children was different in different ages, illness onset years and illness onset seasons (P<0.01). For per IQR increase in PM2.5 concentrations, LOS of HFMD increased by 0.52(0.33, 0.71), 0.50 (95% CI, 0.31–0.69) and 0.46 (95% CI, 0.28–0.65) day in adjusted models at lag 3 days, lag 7days and lag 14 days, respectively. In addition, per IQR increase of BC, SO42−, NH4+, NIT and SOIL were also significantly associated with the LOS of HFMD. Conclusions Our findings corroborated the hypothesis that short-term PM2.5 exposure was associated with increased the LOS of HFMD, and its components (BC, SO42−, NH4+, NIT and SOIL) of PM2.5 might play a key role in the prolonged LOS of HFMD.

Influence of Covid-19 infection on fetal thymus size after recovery

Objectives To investigate the long-term effects of the SARS-CoV-2 infection on the fetal immune system by fetal thymus size measurements with ultrasound (USG). Methods This prospective study was conducted in the Turkish Ministry of Health Ankara City Hospital between November 1, 2020 and April 1, 2021, with recovered, pregnant women, four weeks after they had been confirmed for the SARS-CoV-2 infection by real-time polymerase-chain-reaction (RT-PCR). COVID-19 recovered (CR) pregnant women compared with age-matched pregnant controls in terms of demographic features, fetal thymic-thoracic ratio (TTR), and laboratory parameters. Results There was no difference in demographic features between the two groups. TTR found significantly lower in the CR group than the control group (p=0.001). The fetal TTR showed a significant and moderate correlation with maternal monocyte counts, monocyte to lymphocyte ratio (MLR), and red cell distribution width (RDW); while it did not correlate with lymphocyte counts, c-reactive protein (CRP), and procalcitonin levels. Conclusions The 2019 novel coronavirus disease (COVID-19) reduces fetal thymus size in pregnant women with mild or moderate symptoms after recovery from the infection.

Kikuchi-Fujimoto Disease in the Eastern Mediterranean zone.

Background Kikuchi-Fujimoto disease (KFD) is a rare benign and self-limiting syndrome. We aim to review cases of KFD at our institution as a rare illness in the Arab ethnic descent, and to analyze reports from most countries in the east Mediterranean zone. Methods This is a retrospective study in which the histopathology database was searched for the diagnosis of KFD. A full review of KFD patients’ medical records was done. Data regarding demographic features, clinical presentation, laboratory findings, comorbidities and management protocols were obtained. Published KFD cases from east Mediterranean countries were discussed and compared to other parts of the world. Results Out of 1968 lymph node biopsies studied, 11 (0.6%) cases of KFD were identified. Mean age of patients with KFD was 32 years (4-59). 73% (8/11) were females. The disease was self-limiting in 5 patients (45%), corticosteroid therapy was needed in 4 patients (34%), one patient was treated with methotrexate and one with antibiotics. One patient died as a consequence of lymphoma. Conclusion KFD may still be under diagnosed in our part of the world, likely due to the non-specific mixed symptoms at presentation as well as to the lack of awareness among general practitioners and health care providers. Early diagnosis and treatment is essential to reduce associated morbidity.

Childhood Trauma and Mental Health Status in General Population: A Series Mediation Examination of Psychological Distress in COVID-19 Pandemic and Global Sleep Quality

Background: Coronavirus-2019 (COVID-19) has been coexisting with humans for almost 2 years, consistently impacting people's daily life, medical environment, and mental health. This study aimed to test the series mediation model triggered by childhood trauma, in which perceived psychological impact of COVID-19 pandemic and sleep quality mediated the path sequentially and led to adverse mental health outcomes.Methods: A cross-sectional design involving 817 participants were enrolled via WeChat online survey. Participants completed questionnaires, including demographic features, the Childhood Trauma Questionnaire, Impact of Event Scale-Revised (IES-R) questionnaire, Pittsburgh Sleep Quality Index (PSQI) questionnaire, and Depression, Anxiety, and Stress Scale (DASS-21). Pearson correlations and hierarchical multiple linear regression were employed to examine the association of childhood trauma and psychological stress of COVID-19, sleep quality, and mental health status. In addition, a series mediate analysis was carried out to examine sequence mediating effects of psychological impact of COVID-19 and sleep quality between childhood trauma and mental health status.Results: The results showed that childhood trauma is positively and significantly related to psychological distress of COVID-19 pandemic, sleep quality, and mental health status (p &lt; 0.05). Hierarchical multiple linear regression analysis shown that demographic features explained 4.4, 2.1, and 4.0% of the total variance in DASS-21, IES-R, and PSQI total scale scores, respectively. Adding childhood trauma significantly increased the model variance of DASS-21 (ΔR2 = 0.129, F = 126.092, p = 0.000), IES-R (ΔR2 = 0.062, F = 54.771, p = 0.000), and PSQI total scale scores (ΔR2 = 0.055, F = 48.733, p = 0.000), respectively. Moreover, the series mediation model showed that the perceived impact of the COVID-19 pandemic and sleep quality were sequential mediators between childhood trauma and mental health status (proportion explained: 49.17%, p &lt; 0.05).Conclusion: Amid the ravages of COVID-19, childhood trauma predicts poor mental health status, in part because of greater psychological impact related to COVID-19 and poorer global sleep quality. In order to improve mental health, future researchers should pay more attention to individuals with childhood trauma, for its association with greater stress related to life events and poorer sleep quality.

The Impact of the COVID-19 Pandemic on the Labor Market: An Analysis of Supply and Demand in the Spanish Municipalities

The COVID-19 pandemic represents the largest health and economic crisis in recent history. It has particularly affected the countries of the Mediterranean area, with serious repercussions in terms of not only infections and deaths, but also economic losses. In particular, social distancing measures, severe restrictions, and lockdowns imposed by governments have had serious repercussions on the labor market. The impact of the pandemic on the labor market has prompted numerous researchers to examine and quantify its consequences. However, mainly macroeconomic analyses have been carried out and there is a lack of studies aimed at examining the impact on the labor market in the individual municipalities. This study aims to bridge this gap by examining the consequences of the COVID-19 pandemic on the supply and demand of labor in Spanish municipalities, and the factors that can influence these levels of employment. The results show the relevance of the characteristics of the business fabric in the supply and demand for employment during the first months of the pandemic. In addition, they show that the economic activity of the municipality and the demographic features of the population condition the labor market.