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OBJECTIVES The SARS-CoV-2 pandemic is a destabilizing experience for medical students and resident doctors and troubles their training in the hospital setting. This narrative review aims to identify the effect of health crises on the academic and personal lives of medical trainees and to develop solutions to support them. METHODS EducationSource, MedLine and PsychInfo were consulted on June 30th and December 16th, 2020 to identify the articles explaining the effect of SARS-CoV-1 (2002), A/H1N1 (2009) or SARS-CoV-2 (ongoing) on medical learners. Exclusion criteria included policy papers, letters to the editor or articles detailing the impact on undergraduate medical curricula, on nonmedical trainees, on the residency application process, or the physical impact of the disease. The quality of the selected papers was appraised using CASP for qualitative studies and NHLBI-NIH for cross-sectional studies. RESULTS Ninety-four manuscripts were initially generated and 229, secondarily, of which respectively 14 and 16 were included in the final analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and reviewed qualitatively. It was found that the learners consider their education compromised by exam delays, the suspension of academic activities, and elective surgeries. Anxiety associated with this academic disruption developed. Burnout is exacerbated by the heightened workload. The main difference between the two searches was the long-term effect of COVID-19, including the opportunity for didactic innovation, the worry regarding professional identity formation and the development of mental health issues. The proposed solutions varied from continuous access to mental health resources to the follow-up of learners’ well-being. CONCLUSION It would be interesting to assess the impact of medical trainees’ specialty and country’s development on their experience with COVID-19.

Depuis plus d’un an, la pandémie engendrée par la COVID-19 bouleverse le quotidien par sa diffusion expéditive et la polarisation qu’elle suscite. L’engorgement des services de santé, la suspension d’activités académiques, et le fardeau financier élevé sont concédés par les mesures prescrites visant à endiguer sa propagation. Le retentissement de la pandémie se fait surtout sentir au niveau de la santé mentale en raison de la peur et de l’incertitude inspirées par la nouvelle réalité peinte et de la distanciation sociale ordonnée, entre autres. Elle soulève ainsi la question de bien-être pour les populations qui sont particulièrement vulnérables à cette isolation sociale, telles que les personnes connues pour la dépression ou un trouble alimentaire. D’ailleurs, les personnes souffrant d’anorexie mentale, qui illustre à prime abord une réalité écrasante, se heurtent maintenant contre un obstacle qui rend leur rétablissement un problème davantage convoluté. D’abord, les barrières érigées contre ces patients entravent leur prise en charge efficace et ce, sans le gabarit d’une crise sanitaire. Ensuite, le durcissement des directives de distanciation sociale, quoique puissants agents de contrôle de transmission, nourrit leur trouble alimentaire. Lutter contre sa stigmatisation et assurer l’accès facile à ses ressources de support sont, plus que jamais, d’une importance inouïe.

Aortic valve stenosis (AVS) is a prevailing and life-threatening cardiovascular disease in adults over 75 years of age. However, the molecular mechanisms governing the pathogenesis of AVS are yet to be fully unraveled. With accumulating evidence that Wnt signaling plays a key role in the development of AVS, the involvement of Wnt molecules has become an integral study target in AVS pathogenesis. Thus, we hypothesized that the Wnt/β-catenin pathway mediators, SFRP2, DVL2, GSK3β and β-catenin are dysregulated in patients with AVS. Using immunohistochemistry, Real-Time qPCR and Western blotting, we investigated the presence of SFRP2, GSK-3β, DVL2, and β-catenin in normal and stenotic human aortic valves. Markedly higher mRNA and protein expression of GSK-3β, DVL2, β-catenin and SFRP2 were found in stenotic aortic valves. This was further corroborated by observation of their abundant immunostaining, which displayed strong immunoreactivity in diseased aortic valves. Proteomic analyses of selective GSK3b inhibition in calcifying human aortic valve interstitial cells (HAVICs) revealed enrichment of proteins involved organophosphate metabolism, while reducing the activation of pathogenic biomolecular processes. Lastly, use of the potent calcification inhibitor, Fetuin A, in calcifying HAVICs significantly reduced the expression of Wnt signaling genes Wnt3a, Wnt5a, Wnt5b, and Wnt11. The current findings of altered expression of canonical Wnt signaling in AVS suggest a possible role for regulatory Wnts in AVS. Hence, future studies focused on targeting these molecules are warranted to underline their role in the pathogenesis of the disease.