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Objectives: This observational cross-sectional study examined changes in substance use during the coronavirus disease 2019 (COVID-19) pandemic in the Mexican population and evaluated whether depression or anxiety was associated with these new consumption patterns., Methods: An online survey was distributed to the general population. Participants were questioned about their demographics, situation during the COVID-19 pandemic, and substance consumption patterns. The Patient Health Questionnaire-9 for depression and the Coronavirus Anxiety Scale were used., Results: A total of 866 individuals completed the survey. The mean scores for the Patient Health Questionnaire-9 and Coronavirus Anxiety Scale were 8.89 ± 6.20 and 3.48 ± 3.22, respectively. The preferred substances were alcohol (19%), tobacco (16.5%), and marijuana (5.6%). Consumption of alcohol ( p = 0.042) significantly increased during the pandemic and it was higher in women than in men ( p = 0.040)., Conclusions: Substance use patterns were affected by the pandemic, with an increase in the number of users and consumption rate, as well as the reported psychiatric symptoms.

Confinement and a lack of social interaction are associated with depressive symptoms, low self-esteem, and suicidal thoughts. We report the results of a cross-sectional survey of 1414 junior high school students. The aim was to evaluate the prevalence of depression, anxiety, and stress in Guadalajara, Mexico, during the COVID-19 pandemic. Mean scores on the validated Spanish version of the Depression, Anxiety, and Stress Scale (DASS-21) were found to be 6.15 ± 5.6 for depression, 5.8 ± 5.2 for anxiety, and 8.08 ± 5.3 for stress. Female students scored higher in all three conditions ( p < 0.001). Students who had relatives infected with COVID-19 showed significantly more anxiety than those who did not ( p < 0.004). Although certain demographic groups are at higher risk of manifesting depression, anxiety, and stress, the student population has also been affected by the global impact of the pandemic.

Depression and anxiety are common after months of social isolation, and they can have a negative impact on anyone's quality of life if they are not treated promptly and appropriately. The aim of this study was to determine if the change to online modality courses and the presence of depression or anxiety symptoms during the COVID-19 pandemic was associated with a difference in the college student's academic achievement. This study was a cross-sectional survey in which we used the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). Also, we examined the students' perceptions of their academic performance using the Academic Self-Concept Scale (ASCS). A total of 610 students responded to the survey. The average score on the Academic Self-Concept Scale was 2.76 ± 0.35, the students presented a risk of 61.5% for possible depressive disorder and 52.1% for possible generalized anxiety disorder. The intensity of depression and anxiety symptoms had a significant effect on Academic Self-Concept Scale scores (p < 0.001 and p < 0.05, respectively). The findings indicate that the COVID-19 pandemic has had a direct effect on students' mental health and academic performance., (© 2022. The Author(s).)

The world is facing the worst health crisis in modern history. In addition to general concerns about the effects of COVID-19 on health, hospital personnel are developing numerous mental health conditions. This cross-sectional survey study evaluated the prevalence and severity of anxiety caused by the COVID-19 pandemic using the Coronavirus Anxiety Scale (CAS) in 2136 hospital employees. For the employees who presented scores ranging from 1-20 ( n  = 1090, 51%), the CAS mean score was 4.22 ( SD  = 3.95). The mean score was higher in women than men. By work category, non-clinical hospital personnel presented the highest CAS scores.

Introduction: Intra-abdominal adhesions' main etiology is surgical procedures that commonly require reintervention. Oral treatments with sildenafil, zafirlukast, and pirfenidone have yielded decreased severity of fibrotic phenomena secondary to the introduction of foreign material. This study aimed to evaluate the efficacy of oral zafirlukast, sildenafil, or pirfenidone treatment on reducing or preventing intra-abdominal adhesions in an experimental rat model., Methods: Four groups, each of 10 male Wistar rats weighing 250-300 g, were used. A midline laparotomy was used to excise an area of 1.5 × 1.5 cm and reconstructed with polypropylene mesh fixed to the abdominal wall. After 12 h, oral doses of zafirlukast (1.25 mg/kg, group B), sildenafil (15 mg/kg, group C), or pirfenidone (500 mg/kg, group D) were given every day for 8 days. The control group, A, received no treatment. At day 9, animals were reoperated. The implant was resected after ethically approved euthanasia, and specimens were fixed in 10% formaldehyde for histopathology., Results: Control group A yielded adhesions with greater fibrovascular density and neighboring organ involvement than the other groups (p = 0.001), as well as intense inflammatory infiltrates and numerous granulomas (p = 0.04). Adhesions in group C had less fibrovascular density (p = 0.03) with decreased serosal injuries (p = 0.001) and less organ involvement. Group D had reduced adhesions without organ involvement (p < 0.01) and less inflammatory infiltrates, collagen fibers, and foreign body granulomas than group B or C (p < 0.01)., Conclusions: Oral administration of these agents did not prevent adhesions but ameliorated them. Oral pirfenidone offered the best performance and could be recommended for human use., (© 2021 S. Karger AG, Basel.)

Introduction: Many experimental studies have examined multiple drugs or treatments to improve the healing of intestinal anastomoses. Synthetic prostacyclin analogs, immunosuppressants, erythropoietin, growth hormone, insulin-like growth factor type 1, synthetic metalloproteinases inhibitors, and hyperbaric oxygen therapy have produced promising results in low-risk models of anastomosis dehiscence. However, in high-risk models, only hyperbaric oxygen therapy has been shown to be useful. Pirfenidone (PFD), a commonly used antifibrosing drug, has not been shown to be effective for this purpose. Our objective was to evaluate the effects of PFD on anastomosis healing and adhesion genesis in a low-risk rat model of dehiscence of colonic anastomosis., Methods: An experimental study was conducted on 40 healthy Wistar rats randomly assigned to the control group or PFD experimental group (20 rats in each group). Colon anastomosis was performed 3 cm above the peritoneal reflection using the same technique in all animals. Mechanical resistance was studied by measuring bursting pressure. Adhesions were evaluated macroscopic and histologically using common staining techniques. Animals received the first PFD dose 12 h after surgery at a dose of 500 mg/kg one a day (SID) for 5 consecutive days. On day 6, the animals were reoperated on to measure the bursting pressure in situ and to classify adhesions macroscopically, and the anastomosed colon was resected for histological analysis., Results: There were no deaths, complications, or anastomosis dehiscence in either group. The mean bursting pressure was 120.8 ± 11 mm Hg and 135.5 ± 12.4 in the control and PFD groups, respectively (p < 0.001). The adhesions were less dense and had less inflammatory cell infiltration in the PFD group (p < 0.02 and 0.002, respectively). Collagen content was slightly higher in the PFD group (p = 0.04)., Conclusions: Our results revealed favorable effects of PFD in this low-risk colon anastomosis model; for example, the bursting pressure was higher, and the macroscopic adhesions were soft and exhibited less inflammatory infiltration and higher collagen content in the PFD group than in the control group. The results showing that PFD treatment was associated with better healing of minor adhesions seem to be paradoxical because the therapeutic indications for this drug are directed at treating fibrosing diseases., (© 2022 S. Karger AG, Basel.)

Introduction: Chondromalacia patella is the degeneration of articular cartilage on the posterior facet of the patella and may indicate the onset of osteoarthritis. Conservative management is the main treatment option, and surgical intervention is considered the last option in a small percentage of patients. Perineural Injection Treatment (PIT) is a recently developed treatment option that is directed adjacent to the peripheral nerves that are the source of pathology causing neurogenic inflammation and pain. Objective: The objective of this study was to evaluate the efficacy of PIT combined with a home physical therapy program in patients with a diagnosis of chondromalacia patella compared with a control group receiving physical therapy only. Methods: Two patient groups were involved in this randomized clinical trial. The first received PIT combined with physical therapy (PIT + PT group) and the second was managed with physical therapy alone (PT group). Both groups were indicated to follow a 6-week home therapy plan afterward. The Western Ontario and McMaster Osteoarthritis Index was used to assess the patients at baseline and 6 months after therapy interventions. Results: Fifty patients (38 women and 12 men, median age 54.7 ± 14.8 years) were included; sex distribution and age did not differ between groups. Both groups had chondromalacia grade II or III, but the degree of gonarthrosis did not differ significantly between groups. The PIT + PT group outperformed PT group for pain (7.3 ± 3.5 vs. 3.2 ± 2.9 points; p  < 0.010), stiffness (3 ± 1.69 vs. 1.6 ± 1.5 points; p  < 0.010), and functional capacity (23.2 ± 10.7 vs. 11.1 ± 8.9 points; p  < 0.010). Conclusions: Compared with physical therapy alone, PIT plus physical therapy reduced pain and stiffness and restored functional capacity. ClinicalTrials.gov Register Number #NCT03515720.

Introduction: Introduction: many obese children will be obese adults unless they adopt and maintain healthy eating and physical activity patterns. Anxiety has been described in overweight and obese children with dysfunctional family environments, with impact on their quality of life; risk for some eating disorder was also found. Objective: to identify anxiety in the presence of food in schoolchildren in Baja California Sur. Material and methods: a cross-sectional study in 406 schoolchildren, from 8 to 13 years of age, was performed: nutritional status calculation, measurements of attitudes towards food (cut-off point > 20), socioeconomic level, type of family, and intake of junk food were collected. Descriptive statistics and association measures were performed using Student's t-test and the chi-squared test. Parents provided their informed consent, and children provided their assent. Results: a total of 406 schoolchildren were evaluated, with ages of 10.4 ± 1.2. Of these, 53 % had healthy weight, 44 % had overweight or obesity, and 3 % were underweight. Functional families predominated at 67 %. A middle socioeconomic level was found in 64 %. In all, 94 % consumed junk food. There is an association between anxiety in the presence of food and socioeconomic status, and anxiety in the presence of food and nutritional status (p = 0.01). In overweight and obese schoolchildren no association was found between study variables. There is anxiety in the presence of food in 40 % of the sample due to external factors, in 5 % because of tiredness or boredom, in 11 % because of negative feelings. Conclusion: there is an association between anxiety, socioeconomic status, and nutritional status. Anxiety in the presence of food occurred in 54.7 % of cases.

Background and Aim: Analysis of ascitic fluid is necessary to determine the etiology and to distinguish portal hypertension (PH)-related and unrelated ascites. Numerous diagnostic parameters have been studied, but no single parameter has completely distinguished these. We aimed to validate the serum albumin-ascites gradient (SAAG) for the diagnosis of ascites secondary to PH and to establish cutoff points to predict PH using its sensitivity and specificity., Methods: This was a cross-sectional study conducted on patients diagnosed with ascites of any etiology. The SAAG and albumin concentration in ascitic fluid (AFA) were measured to establish their sensitivity and specificity for determining the presence or absence of PH. Cutoff points and levels of statistical significance were established based on the area under the curve., Results: Eighty-seven patients were evaluated, of whom 74 (84%) were men, with an average age of 54.0 ± 13.6 years. Seventy-two (83%) were diagnosed at admission with PH-related ascites and 15 (17%) with non-PH-related ascites. SAAG correctly classified 48 (67%) patients, but 24 (33%) were classified incorrectly, while AFA classified 59 (82%) correctly and only 13 (17%) incorrectly. The diagnostic accuracy of SAAG was 57 versus 73% for AFA. AFA had a sensitivity of 82% and specificity of 66% (95% confidence interval [CI]: 0.63-0.93), while SAAG had a sensitivity of 66% but a specificity of 86% (95% CI: 0.72-0.95)., Conclusions: The SAAG showed poor diagnostic performance with low sensitivity but high specificity. The diagnostic accuracy of AFA is superior to that of SAAG in discriminating between PH and non-PH ascites., (© 2020 The Authors. JGH Open published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.)

Background: Patients admitted to the intensive care unit (ICU) experience sleep disruption caused by a variety of conditions, such as staff activities, alarms on monitors, and overall noise. In this study, we explored the relationship between noise and other factors associated with poor sleep quality in patients., Methods: This was a prospective cohort study. We used the Richards-Campbell Sleep Questionnaire to explore sleep quality in a sample of patients admitted to the ICU of a private hospital. We measured the noise levels within each ICU three times a day. After each night during their ICU stay, patients were asked to complete a survey about sleep disturbances. These disturbances were classified as biological (such as anxiety or pain) and environmental factors (such as lighting and ICU noise)., Results: We interviewed 71 patients; 62% were men (mean age 54.46 years) and the mean length of stay was 8 days. Biological factors affected 36% and environmental factors affected 20% of the patients. The most common biological factor was anxiety symptoms, which affected 28% of the patients, and the most common environmental factor was noise, which affected 32.4%. The overall mean recorded noise level was 62.45 dB. Based on the patients' responses, the environmental factors had a larger effect on patients' sleep quality than biological factors. Patients who stayed more than 5 days reported less sleep disturbance. Patients younger than 55 years were more affected by environmental and biological factors than were those older than 55 years., Conclusions: Patient quality of sleep in the ICU is associated with environmental factors such as noise and artificial lighting, as well as biological factors related to anxiety and pain. The noise level in the ICU is twice that recommended by international guides. Given the stronger influence of environmental factors, the use of earplugs or sleeping masks is recommended. The longer the hospital stay, the less these factors seem to affect patients' sleep quality.