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12 pages, 302 KiB

Open AccessArticle

Changes in Pancreatic Cancer Management and Surgical Treatment During the COVID-19 Pandemic

by Aida Puia, Catalin Vladut Ionut Feier, Vasile Gaborean, Raluca Bodea, Florin Graur, Florin Zaharie, Nadim Al-Hajjar and Ion Cosmin Puia

Medicina 2024, 60(12), 1924; https://doi.org/10.3390/medicina60121924 - 22 Nov 2024

Abstract

Background and Objectives: This study evaluated the impact of the COVID-19 pandemic on the surgical management of pancreatic ductal adenocarcinoma (PDAC) at a tertiary care hospital in Romania. The objective was to compare surgical volumes, tumor characteristics, and patient outcomes across three [...] Read more.

Background and Objectives: This study evaluated the impact of the COVID-19 pandemic on the surgical management of pancreatic ductal adenocarcinoma (PDAC) at a tertiary care hospital in Romania. The objective was to compare surgical volumes, tumor characteristics, and patient outcomes across three periods: pre-COVID, pandemic, and post-COVID. Materials and Methods: A retrospective analysis of 622 PDAC patients who underwent surgery between February 2018 and February 2024 was conducted. The key variables analyzed included tumor size, type of surgery (curative vs. palliative), use of neoadjuvant therapy, postoperative complications, and ICU monitoring, among others. Results: During the pandemic, there was a 25% decrease in surgical interventions compared the number performed during the pre-pandemic period, with a significant increase in the number of patients undergoing surgical intervention following neoadjuvant treatment (p = 0.009) in the post-pandemic period. Post-pandemic, surgical volumes increased by 10%, and tumor sizes were smaller (p = 0.029). Postoperative outcomes, such as complications, remained stable across the periods, but intensive care unit monitoring increased significantly during the pandemic and post-pandemic periods. Hospital stay durations were significantly shorter during and after the pandemic (p < 0.05). Conclusions: The COVID-19 pandemic led to delays in PDAC surgeries, but post-pandemic improvements in surgical volumes and early diagnosis are evident; however, further optimization of screening and treatment protocols is essential for improving patient outcomes. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

12 pages, 316 KiB

Open AccessArticle

Surgical Challenges During the COVID-19 Crisis: A Comparative Study of Inguinal Hernia Treatment in Romania

by Catalin Vladut Ionut Feier, Calin Muntean, Vasile Gaborean, Razvan Constantin Vonica, Alaviana Monique Faur, Marius-Sorin Murariu and Sorin Olariu

Medicina 2024, 60(11), 1825; https://doi.org/10.3390/medicina60111825 - 6 Nov 2024

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Abstract

Background and Objectives: The COVID-19 pandemic disrupted healthcare systems worldwide, leading to the postponement of elective surgeries, including inguinal hernia repair (IHR), as healthcare resources prioritized critical care. This study aims to evaluate the impact of the pandemic on the incidence and [...] Read more.

Background and Objectives: The COVID-19 pandemic disrupted healthcare systems worldwide, leading to the postponement of elective surgeries, including inguinal hernia repair (IHR), as healthcare resources prioritized critical care. This study aims to evaluate the impact of the pandemic on the incidence and outcomes of IHR procedures. Materials and Methods: A retrospective review was conducted on 604 patients who underwent IHR over six years, spanning pre-pandemic, pandemic, and post-pandemic periods. Data on patient demographics, type of surgical procedure (elective or emergency), use of mesh, surgical duration, hospitalization period, and postoperative outcomes were analyzed across the three time frames. Results: Patient age remained consistent across the three periods, but a significant increase in female patients was observed during and after the pandemic (p < 0.001). Elective IHR surgeries significantly decreased during the pandemic (p < 0.001), paralleled by an increase in emergency cases (p = 0.004). In the post-pandemic period, elective surgeries rebounded, while emergency interventions declined (21.9% vs. 10.3%). Mesh repair usage increased notably in the post-pandemic phase (p < 0.001). Although surgeries took longer during the pandemic (p < 0.001), both total and postoperative hospital stays were reduced during and after the pandemic (p < 0.001). Minimal postoperative complications were reported throughout, with only one mortality during the pandemic. Conclusions: This study highlights the need for robust healthcare strategies to maintain elective surgical care during global crises, as delays in IHR may elevate risks for complications like hernia incarceration and strangulation. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

14 pages, 545 KiB

Open AccessArticle

Impulsivity and Its Association with Depression and Anxiety in the Normal Egyptian Population Post COVID-19 Pandemic

by Marwa S. Ismael, Marwa O. Elgendy, Ammena Y. Binsaleh, Asmaa Saleh, Mohamed E. A. Abdelrahim and Hasnaa Osama

Medicina 2024, 60(8), 1367; https://doi.org/10.3390/medicina60081367 - 22 Aug 2024

Cited by 1 | Viewed by 835

Abstract

Background and Objectives: It is well known that depression, anxiety, and impulsiveness are interrelated; however, studies that have assessed their association with the coronavirus outbreak are scarce. Hence, our study aimed to evaluate the impulsivity incidence and its correlation with anxiety and depression [...] Read more.

Background and Objectives: It is well known that depression, anxiety, and impulsiveness are interrelated; however, studies that have assessed their association with the coronavirus outbreak are scarce. Hence, our study aimed to evaluate the impulsivity incidence and its correlation with anxiety and depression following COVID-19 infection between November 2022 and June 2023. Materials and Methods: The 201 participants completed the Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM-A), Sheehan Disability Scale (SDS), and short UPPS-P scales (urgency, premeditation, perseverance, sensation seeking, and positive urgency) to allow us to determine their anxiety and depression symptoms, functional impairment, and impulsivity, respectively. Results: Among our respondents, 22%, and 26.7% had moderate to severe anxiety and depression. The short UPPS-P scale significantly correlated with the HAM-A and HDRS scales. Participants with positive COVID-19 infection showed significantly higher functional impairment scores, especially in the work/study domain (mean (SD): 3.12 (2.2) vs. 2.43 (2.3); p = 0.037). COVID-19-related disruption significantly correlated with negative and positive urgency, HAM-A, HDRS, and the SDS total and subscales. Conclusions: Our findings showed a notable increase in anxiety, depression, and functional impairment among the population following COVID-19 infection. Our research highlights the correlation between impulsivity and the psychological distress experienced following the pandemic. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

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10 pages, 473 KiB

Open AccessArticle

The Impact of Long COVID on the Quality of Life

by Angela Cozma, Adela-Viviana Sitar-Tăut, Olga Hilda Orășan, Daniel Corneliu Leucuța, Tinca-Codruța Pocol, Octavia Sălăgean, Camil Crișan, Nicolae-Dan Sporiș, Andrada-Luciana Lazar, Toma-Vlad Mălinescu, Andreea-Maria Ganea, Călin Vasile Vlad, Melinda Horvat, Mihaela Sorina Lupșe and Violeta Briciu

Medicina 2024, 60(8), 1359; https://doi.org/10.3390/medicina60081359 - 21 Aug 2024

Viewed by 950

Abstract

Background and Objectives: The term long COVID refers to patients with a history of confirmed COVID-19 infection, who present symptoms that last for at least 2 months and cannot be explained by another diagnosis. Objectives: The present study aims to determine the [...] Read more.

Background and Objectives: The term long COVID refers to patients with a history of confirmed COVID-19 infection, who present symptoms that last for at least 2 months and cannot be explained by another diagnosis. Objectives: The present study aims to determine the most common symptoms of the long COVID syndrome and their impact on the quality of life. Materials and Methods: A prospective observational study was conducted on patients diagnosed with mild and moderate COVID-19 (based on a positive SARS-CoV-2 molecular diagnostic or rapid antigen test and severity form definition) at the Clinical Hospital of Infectious Diseases, Cluj-Napoca, Romania. Clinical examinations with detailed questions about symptoms were performed at the time of the diagnosis of COVID-19 and the six-month follow-up. Two years after COVID-19 infection, patients were invited to complete an online quality-of-life questionnaire regarding long COVID symptoms. Results: A total of 103 patients (35.92% males) with a mean age of 41.56 ± 11.77 were included in this study. Of the total number of patients, 65.04% presented mild forms of COVID-19. Data regarding the vaccination status showed that 83.5% were vaccinated against SARS-CoV-2. The most common symptoms at diagnosis were cough (80.6%), fatigue (80.4%), odynophagia (76.7%), and headaches (67.6%), with female patients being statistically more likely to experience it (p = 0.014). Patients with moderate forms of the disease had higher levels of both systolic (p = 0.008) and diastolic (p = 0.037) blood pressure at diagnosis, but no statistical difference was observed in the 6-month follow-up. The most common symptoms at 2 years (in 29 respondent subjects) were represented by asthenia (51.7%), headache (34.5%), memory disorders (27.6%), abdominal meteorism (27.6%), and arthralgia (27.6%). In terms of cardiovascular symptoms, fluctuating blood pressure values (20.7%), palpitations (17.2%), and increased heart rate values (17.2%) were recorded. Conclusions: If at the time of diagnosis, the most frequent manifestations of the disease were respiratory, together with headache and fatigue, at re-evaluation, asthenia, decreased effort tolerance, and neuropsychiatric symptoms prevailed. Regarding the cardiovascular changes as part of the long COVID clinical picture, some patients developed prehypertension, palpitations, and tachycardia. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

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11 pages, 797 KiB

Open AccessArticle

Challenges and Solutions during the COVID-19 Pandemic: Hospitalization and Performance in Elective Pediatric Surgeries

by Miro Jukić, Petra Tokić, Sara Elezović Baloević and Zenon Pogorelić

Medicina 2024, 60(7), 1072; https://doi.org/10.3390/medicina60071072 - 29 Jun 2024

Viewed by 766

Abstract

Background and Objectives: This retrospective study aimed to investigate the impact of the COVID-19 pandemic on the most frequently performed elective pediatric surgical procedures and the number of hospitalizations and compare it to the pre-pandemic and post-pandemic periods. Materials and Methods: [...] Read more.

Background and Objectives: This retrospective study aimed to investigate the impact of the COVID-19 pandemic on the most frequently performed elective pediatric surgical procedures and the number of hospitalizations and compare it to the pre-pandemic and post-pandemic periods. Materials and Methods: The subjects were patients under 18 years of age who were regularly admitted for selected elective procedures in a single tertiary center in Croatia from 1 March to 31 August of 2019, 2020, 2021, and 2022. Data were collected from the electronic logs of surgical procedures and hospital admissions, logs of one-day surgeries, patients’ medical records, and discharge letters. The primary outcome of this study was to determine the evolution of the number of elective surgical procedures before, during, and after the peak of the COVID-19 pandemic; also, we aimed to confirm and objectify global data and statements about the decrease in the number of hospital admissions and surgical procedures. Secondary outcome measures included the length of hospitalization, the number and types of complications, and readmissions. Results: In 2020, the number of elective procedures decreased by 28.3% and the number of hospitalizations decreased by 36.2%; in 2021, the number of elective procedures decreased by 30.8% and the number of hospitalizations decreased by 14.2% compared to the pre-pandemic period (2019). In 2022, there was a 22.8% increase in elective procedures and a 2.9% decrease in hospitalizations compared to 2019. No statistical difference was found in the rates of complications between the individual years studied in terms of complications (p = 0.869). Conclusions: The number of elective procedures and hospitalizations during the COVID-19 pandemic has decreased significantly compared to the pre-pandemic period. After the healthcare system adapted to the conditions of the pandemic, the number of elective procedures increased significantly despite COVID-19, while the number of hospitalizations remained approximately the same as before the pandemic. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

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11 pages, 289 KiB

Open AccessArticle

Unveiling the Effects of the COVID-19 Pandemic on Lung Cancer Surgery

by Gabriel Veniamin Cozma, Calin Muntean, Alaviana Monique Faur, Vasile Gaborean, Ioan Adrian Petrache and Catalin Vladut Ionut Feier

Medicina 2024, 60(6), 964; https://doi.org/10.3390/medicina60060964 - 11 Jun 2024

Viewed by 1086

Abstract

The aim of this study is to investigate the impact of the COVID-19 pandemic on the surgical treatment of lung cancer patients. Data from patients who underwent surgery during the pandemic were analyzed and compared to pre-pandemic and post-pandemic periods. Multiple parameters were [...] Read more.

The aim of this study is to investigate the impact of the COVID-19 pandemic on the surgical treatment of lung cancer patients. Data from patients who underwent surgery during the pandemic were analyzed and compared to pre-pandemic and post-pandemic periods. Multiple parameters were examined, and their changes yielded significant results compared to other periods of the study. The statistical analysis revealed a significant decrease in the number of surgical interventions during the pandemic (p < 0.001), followed by a significant rebound thereafter. During this period, there was a significant increase in the T stage of cancer compared to both pre-pandemic and post-pandemic periods (p = 0.027). Additionally, the mean Charlson comorbidity index score was significantly higher during the pandemic compared to the pre-pandemic period (p = 0.042). In this crisis period, a significant decrease was recorded in both the total hospitalization duration (p = 0.015) and the pre-operative hospitalization duration (p = 0.006). These findings provide evidence of significant changes in clinical and therapeutic strategies applied to lung cancer surgery patients during the study period. The pandemic has had a substantial and complex impact, the full extent of which remains to be fully understood. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

15 pages, 362 KiB

Open AccessArticle

Association between Presenteeism, Associated Factors, and Outcomes among Intern Physicians in Public Hospitals during the COVID-19 Pandemic: A Cross-Sectional Study

by Vithawat Surawattanasakul, Wuttipat Kiratipaisarl and Penprapa Siviroj

Medicina 2024, 60(6), 962; https://doi.org/10.3390/medicina60060962 - 10 Jun 2024

Viewed by 1195

Abstract

Background and Objectives: Presenteeism, when employees continue to work despite being sick, may have increased among intern physicians during the COVID-19 pandemic due to the necessity of performing unfamiliar tasks. This study aimed to investigate the prevalence of presenteeism among intern physicians (IPs) [...] Read more.

Background and Objectives: Presenteeism, when employees continue to work despite being sick, may have increased among intern physicians during the COVID-19 pandemic due to the necessity of performing unfamiliar tasks. This study aimed to investigate the prevalence of presenteeism among intern physicians (IPs) in Thailand, its associated factors, and outcomes. Material and Methods: A total of 254 IPs participated in this cross-sectional study conducted from June to July 2022. Participants completed a nationwide online questionnaire including demographics, financial status, underlying diseases, hospital location and affiliation, department, resource problems, manpower shortage, workload intensity, presenteeism, and its outcomes. IPs were recruited via various social media platforms. Statistical analysis was performed using multivariable zero-inflated Poisson regression and multivariable linear regression. Results: The average age of IPs was 25.5 years (SD 1.9), and 57.5% were female. The majority of IPs reported dealing with resource problems (74.8%), insufficient manpower (94.9%), and intense workload (83.5%). Presenteeism was prevalent among 63.8% of IPs, with the most common of the diseases being allergic rhinitis (31.3%). IPs with underlying diseases had an increased rate of presenteeism (adjusted odds ratio (aOR) 2.50, 95% confidence interval (CI) 1.33–4.55). IPs working in community hospitals during their rotations exhibited a lower rate of presenteeism (aOR 0.39, 95% CI 0.16–0.94) compared to other departments within general or regional hospitals. The IPs frequently exposed to insufficient manpower had an increased rate of presenteeism (aOR 4.35, 95% CI 1.02–20.00) compared to those not exposed. Additionally, IPs with presenteeism had more exhaustion (β 1.40, 95% CI 0.33 to 2.46), lower perceived well-being (β −0.65, 95% CI −1.26 to −0.03), and job satisfaction (β −0.33, 95% CI −0.63 to −0.03). Conclusions: During COVID-19, intern physicians in Thailand often exhibit presenteeism due to physical conditions, resource scarcity, and personnel shortages, impacting exhaustion, well-being, and job satisfaction. Recommendations include assessing healthcare workforces, allocating resources more effectively, enforcing policies to promote responsible use of sick leave, and implementing sick leave systems. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

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11 pages, 448 KiB

Open AccessArticle

Insights from Chilean NCDs Hospitalization Data during COVID-19

by Jaime Andrés Vásquez-Gómez and Chiara Saracini

Medicina 2024, 60(5), 770; https://doi.org/10.3390/medicina60050770 - 7 May 2024

Viewed by 1129

Abstract

The COVID-19 pandemic has affected the lifestyles of people of all ages, conditions and occupations. Social distance, remote working, changes in diet and a lack of physical activity have directly and indirectly affected many aspects of mental and physical health, particularly in patients [...] Read more.

The COVID-19 pandemic has affected the lifestyles of people of all ages, conditions and occupations. Social distance, remote working, changes in diet and a lack of physical activity have directly and indirectly affected many aspects of mental and physical health, particularly in patients with many comorbidities and non-communicable diseases (NCDs). In our paper, we analyzed COVID-19 hospitalized and non-hospitalized cases according to comorbidities to assess the average monthly percentage change (AMPC) and monthly percentage change (MPC) using open access data from the Chilean Ministry of Science, Technology, Knowledge and Innovation. As expected, the infection mainly affected patients with comorbidities, including cardiovascular risk factors. The hospitalized cases with obesity and chronic lung disease increased throughout the period of June 2020–August 2021 (AMPC = ↑20.8 and ↑19.4%, respectively, p < 0.05), as did all the non-hospitalized cases with comorbidities throughout the period (AMPC = ↑15.6 to ↑30.3 [p < 0.05]). The increases in hospitalizations and non-hospitalizations with comorbidities may be associated with physical inactivity. A healthy lifestyle with regular physical activity may have had a protective effect on the COVID-19 severity and related events in the post-pandemic period, especially for the NCD population. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

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8 pages, 317 KiB

Open AccessArticle

O₂ Saturation Predicted the ICU Stay of COVID-19 Patients in a Hospital at Altitude: A Low-Cost Tool for Post-Pandemic

by Jaime Vásquez-Gómez, Lucero Gutierrez-Gutierrez, Pablo Miranda-Cuevas, Luis Ríos-Florez, Luz Casas-Condori, Marcia Gumiel and Marcelo Castillo-Retamal

Medicina 2024, 60(4), 641; https://doi.org/10.3390/medicina60040641 - 17 Apr 2024

Viewed by 990

Abstract

Background and Objectives: Patients at high altitudes with COVID-19 may experience a decrease in their partial oxygen saturation (PO₂S) levels. The objective was to assess the association between PO₂S and intensive care unit (ICU) stay in patients at [...] Read more.

Background and Objectives: Patients at high altitudes with COVID-19 may experience a decrease in their partial oxygen saturation (PO₂S) levels. The objective was to assess the association between PO₂S and intensive care unit (ICU) stay in patients at high altitudes with COVID-19. Materials and Methods: Clinical records of 69 COVID-19 patients (36% women) admitted to the ICU were analyzed. Median values were considered for intra-group categories (“≤11 days” and “>11 days” in the ICU) and for PO₂S height categories (“<90%” and “≥90%”). Logistic regression and linear regression models adjusted for confounding variables were used. Results: Patients with >11 days in the ICU had 84% lower odds of having a PO₂S ≥ 90% (OR: 0.16 [CI: 0.02, 0.69], p = 0.005) compared to those with ≤11 days in the ICU. An increase in PO₂S by 1% reduced ICU stay by 0.22 days (β: −0.22 [CI: −0.33, −0.11], p < 0.001), potentially leading to a reduction of up to 1.44 days. Conclusions: PO₂S is a crucial factor in estimating ICU stays for COVID-19 patients at high altitudes and serves as an accessible and cost-effective measure. It should be used in infected patients to complement the prognosis of post-pandemic ICU stay. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

14 pages, 1792 KiB

Open AccessArticle

Impact of Foodborne Disease in Taiwan during the COVID-19 Pandemic

by Ya-Lu Yang, Cheng-Chueh Chen, Pi-Wei Chin, Chun-Gu Cheng and Chun-An Cheng

Medicina 2024, 60(3), 505; https://doi.org/10.3390/medicina60030505 - 19 Mar 2024

Viewed by 1927

Abstract

Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic originated in Wuhan, China, in December 2019, the first case diagnosed since January 2020 in Taiwan. The study about the potential impact of the COVID-19 pandemic on event, location, food source, and pathogens [...] Read more.

Background and Objectives: The coronavirus disease 2019 (COVID-19) pandemic originated in Wuhan, China, in December 2019, the first case diagnosed since January 2020 in Taiwan. The study about the potential impact of the COVID-19 pandemic on event, location, food source, and pathogens of foodborne disease (FBD) is limited in Taiwan. Our aim in this study is to investigate FBD in the context of the COVID-19 pandemic. Materials and Methods: We collected publicly available annual summary data from the FBD dataset in the Taiwan Food and Drug Administration and Certifiable Disease on reported FBD in Taiwan from 2019 to 2020. We used logistic regression to evaluate changes in the occurrence or likelihood of FBD cases and Poisson regression to examine the relative risk (RR) between FBD and climate factors. Results: Similar events occurred in 2019 and 2020, but the total number of FBD cases decreased from 6935 in 2019 to 4920 in 2020. The places where FBD decreased were in schools, hospitals, outdoors, vendors, and exteriors. The top place in FBD shifted from schools to restaurants. The top food source for FBD has changed from boxed food to compound food. Bacillus cereus and Salmonella emerged as the top two observed bacterial pathogens causing FBD. The risk of FBD cases increased with a higher air temperature, with an RR of 1.055 (1.05–1.061, p < 0.001) every 1 °C. Conclusion: The incidence of FBD decreased significantly during the COVID-19 pandemic in Taiwan. This decline may be attributed to protective measures implemented to control the spread of the virus. This shift in locations could be influenced by changes in public behavior, regulations, or other external factors. The study emphasizes the importance of understanding the sources and effectiveness of severe infection prevention policies. The government can use these findings to formulate evidence-based policies aimed at reducing FBD cases and promoting public health. Consumers can reduce the risk of FBD by following safe food handling and preparation recommendations. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

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10 pages, 480 KiB

Open AccessArticle

Menstrual Changes Following COVID-19 Vaccination: A Cross-Sectional Study

by Nahid Ibrahim Fallatah, Bushra Omar Alrehaili, Salhah Saleh Alsulami and Abdulmohsen Hamdan Al-Zalabani

Medicina 2024, 60(2), 206; https://doi.org/10.3390/medicina60020206 - 25 Jan 2024

Cited by 4 | Viewed by 1971

Abstract

Background and Objectives: Menstrual changes, including altered cycle length and bleeding patterns, have been reported following COVID-19 vaccination. This study aimed to determine the prevalence and types of menstrual changes occurring after COVID-19 vaccination among female students and staff at a university [...] Read more.

Background and Objectives: Menstrual changes, including altered cycle length and bleeding patterns, have been reported following COVID-19 vaccination. This study aimed to determine the prevalence and types of menstrual changes occurring after COVID-19 vaccination among female students and staff at a university in Saudi Arabia. Materials and Methods: A cross-sectional study was conducted among women aged 18–39 years who received at least one dose of a COVID-19 vaccine. Eligible participants, including university students and staff, were recruited between May 2022 and November 2022. Participants completed a questionnaire detailing their sociodemographic characteristics, general medical and reproductive history, and menstrual characteristics before and after vaccination. The prevalence of various menstrual changes (cycle length, bleeding days, flow, and mid-cycle spotting) was calculated. The demographic factors associated with menstrual changes were analyzed using chi-squared tests. Results: The 472 included participants had a mean age of 20.9 years, and 95.3% were unmarried. Changes in menstrual cycle characteristics after COVID-19 vaccination were reported by 54.7% of respondents overall. The most common change was in cycle length, followed by the number of menstruation days and bleeding flow. Menstrual changes were not associated with age, BMI, occupation, marital status, or medical history. Changes in intermenstrual bleeding were more frequently reported after the third dose of the Pfizer vaccine compared to the Moderna vaccine (p = 0.014). Conclusions: More than half of the recruited female students and staff reported menstrual changes following COVID-19 vaccination, with altered cycle length being the most common. The potential underlying mechanisms and implications of these menstrual alterations require further investigation. These findings provide evidence of the menstrual side effects of COVID-19 vaccines among women in Saudi Arabia. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

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19 pages, 382 KiB

Open AccessArticle

Evolving Mental Health Dynamics among Medical Students amid COVID-19: A Comparative Analysis of Stress, Depression, and Alcohol Use among Medical Students

by Codruța Alina Popescu, Ana Maria Tegzeșiu, Soimița Mihaela Suciu, Bogdan Florin Covaliu, Sebastian Mihai Armean, Tudor Adrian Uță and Alexandru Constantin Sîrbu

Medicina 2023, 59(10), 1854; https://doi.org/10.3390/medicina59101854 - 18 Oct 2023

Cited by 4 | Viewed by 1924

Abstract

Background and Objectives: The ongoing COVID-19 pandemic has posed an array of new challenges for medical students worldwide. Amidst academic rigors, students are confronted with unique stressors, potentially affecting their mental health and substance use. This study aimed to investigate the multifaceted [...] Read more.

Background and Objectives: The ongoing COVID-19 pandemic has posed an array of new challenges for medical students worldwide. Amidst academic rigors, students are confronted with unique stressors, potentially affecting their mental health and substance use. This study aimed to investigate the multifaceted effects of depression, alcohol use, and stress on medical students and discern how these factors have been amplified by the pandemic’s circumstances, and to identify predictors of mental distress during the COVID-19 pandemic period. Materials and Methods: Two online anonymous and cross-sectional surveys were conducted at the University of Medicine and Pharmacy “Iuliu Hatieganu” in Romania among medical students in 2018 and in 2022. Data were gathered via online questionnaires distributed through closed student groups on social media platforms, with a total of 1061 participants, to investigate stress, depression, alcohol and drug use, and the impact of the pandemic and online education on mental health, maintaining anonymity and ethical approval. The Medical Student Stress Questionnaire (MSSQ) was employed to measure different aspects of stress, the Beck Depression Inventory (BDI) provided insights into the participants’ depressive symptoms, and for the assessment of alcohol consumption habits, the Alcohol Use Disorders Identification Test (AUDIT) was utilized. Results: Our findings showed a significant decrease in mean depression scores (13.81 vs. 11.56, with p < 0.001) from 2018 to 2022. In 2018, students scored significantly higher in the overall stress-related domains. Additionally, being female, facing financial constraints, and being in pre-clinical years emerged as predictors of heightened academic-related stress and depressive symptoms. Students who had experienced the loss of a family member due to COVID-19 exhibited a statistically significant rise in their average BDI score and current anxiety levels. Conclusions: The pandemic, despite introducing new stressors, may have indirectly fostered an increased focus on students’ mental health, leading to more refined support mechanisms. Specialized interventions, taking into account gender and financial problems, are needed to address the multifaceted challenges faced by medical students. Our study highlights the ongoing need to nurture both the academic and emotional strength of future medical practitioners. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

Review

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32 pages, 1478 KiB

Open AccessReview

Status of Healthy Choices, Attitudes and Health Education of Children and Young People in Romania—A Literature Review

by Alexandra-Ioana Roșioară, Bogdana Adriana Năsui, Nina Ciuciuc, Dana Manuela Sîrbu, Daniela Curșeu, Anca Lucia Pop, Codruța Alina Popescu and Monica Popa

Medicina 2024, 60(5), 725; https://doi.org/10.3390/medicina60050725 - 27 Apr 2024

Cited by 1 | Viewed by 2266

Abstract

Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide [...] Read more.

Background and Objectives: This study aims to assess the health status and factors influencing healthy choices among children and young people in Romania, as well as the efficacy of related health education programs. Through understanding these dynamics, the study seeks to provide insights that can shape targeted interventions, policies, and educational strategies to improve this demographic’s overall health and well-being. Materials and Methods: For this study, we performed a literature review of original published papers on the health status, healthy habits, health education, predisposition to making healthy choices in the future, and accessibility to the paediatric health system of Romanian children and young people, as well as the effects of different types of educational interventions on this demographic in Romania. Results: The prevalence of dental caries is high in Romania. In terms of eating habits and nutritional status, a worrying proportion of children are overweight or obese, which can lead to a variety of future physical and psychological problems. In terms of physical activity, few adolescents demonstrate regular fitness practices. Romania presents an increase in alcohol and tobacco consumption among adolescents. The mental health of students has become a pressing public health concern, exacerbated by the COVID-19 pandemic. The use of social networks is linked to mental health issues among young people. Romania still has one of the highest rates of sexually transmitted diseases and faces a high incidence of cervical cancer, with a mortality rate three times higher than the EU average. High rates of teenage pregnancies are linked to limited information about sexuality and a lack of access to family planning at a young age. There are large discrepancies in the accessibility of medical services between urban and rural areas. Conclusions: Romania faces significant obstacles to providing high-quality healthcare to children and young people. Improving nutrition, immunisation rates, and access to medical services represent essential areas for enhancing the health of children and young people in Romania. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

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10 pages, 287 KiB

Open AccessReview

Current German Recommendations and International Research on the Use of COVID-19 Boosters among Health Care Providers in 2024: A Narrative Review

by Poramate Pitak-Arnnop, Popchai Ngamskulrungroj, Nithi Mahanonda, Prim Auychai, Benjamin Frech, Veronika Shavlokhova and Christian Stoll

Medicina 2024, 60(3), 385; https://doi.org/10.3390/medicina60030385 - 25 Feb 2024

Cited by 1 | Viewed by 2446

Abstract

While the World Health Organization (WHO) has de-escalated coronavirus disease 2019 (COVID-19) from a global health emergency, ongoing discussions persist as new viral variants. This article aimed to consolidate German recommendations and international research to offer health care providers (HCPs) a comprehensive guide [...] Read more.

While the World Health Organization (WHO) has de-escalated coronavirus disease 2019 (COVID-19) from a global health emergency, ongoing discussions persist as new viral variants. This article aimed to consolidate German recommendations and international research to offer health care providers (HCPs) a comprehensive guide on COVID-19 boosters in 2024. The review outlines key recommendations from the German Robert Koch Institute. HCPs should receive COVID-19 boosters at least 12 months after their last vaccination or COVID-19 infection, contingent on the prevalent viral variant(s) in the region. However, excessive doses and/or frequent boosters, especially with mRNA vaccines, may lead to immune imprinting, T-cell exhaustion, and immunoglobulin (Ig) switching. Notably, this review highlights the significance of Ig, particularly IgA and IgG subclasses, in influencing infection risk and disease progression. Furthermore, it explores the implications of mRNA vaccine technology and potential adverse effects related to excessive dosing. In conclusion, this article provides a comprehensive analysis of COVID-19 vaccine boosters for HCPs, synthesising current recommendations, scientific debates, and considerations for optimising protection against SARS-CoV-2 in the evolving landscape of the post-pandemic era. Full article

(This article belongs to the Special Issue Impact on Human Health, Lifestyle and Quality of Care after COVID-19)

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