On the origin and development of glioblastoma: multifaceted role of perivascular mesenchymal stromal cells

Glioblastoma, IDH wild-type is the most common and aggressive form of glial tumors. The exact mechanisms of glioblastoma oncogenesis, including the identification of the glioma-initiating cell, are yet to be discovered. Recent studies have led to the hypothesis that glioblastoma arises from neural stem cells and glial precursor cells and that cell lineage constitutes a key determinant of the glioblastoma molecular subtype. These findings brought significant advancement to the comprehension of gliomagenesis. However, the cellular origin of glioblastoma with mesenchymal molecular features remains elusive. Mesenchymal stromal cells emerge as potential glioblastoma-initiating cells, especially with regard to the mesenchymal molecular subtype. These fibroblast-like cells, which derive from the neural crest and reside in the perivascular niche, may underlie gliomagenesis and exert pro-tumoral effects within the tumor microenvironment. This review synthesizes the potential roles of mesenchymal stromal cells in the context of glioblastoma and provides novel research avenues to better understand this lethal disease.

Immigration projects among young doctors in Tunisia: Prevalence, destinations and causes

Introduction

The shortage of doctors has become a worrying problem in Tunisia. It is influenced by the phenomenon of immigration which remains poorly studied despite its magnitude.

Objectives

To describe the migration intentions of Tunisian young doctors and to identify the associated factors that influence their decisions.

Methods

This is a cross-sectional, analytical survey conducted between January and June 2019. It included all young doctors practicing in academic hospitals of Sousse (Tunisia). Data collection was based on a standardized self-administered questionnaire.

Results

A total of 182 valid questionnaires were collected. The median age was 26.9±2.5 years and the sex-ratio was 0.47. Immigration projects were reported by 38.5% of participants. The main destination was France (36.3%%). The main contributing factors were marital status (p<10-3), resident status (p=0.002), surgical specialty (p<10-3), personal dissatisfaction (p=0.003), underpayment (p<10-3), workload and difficult work conditions (p<10-3), lack of appropriate training (p<10-3), financial crisis and economic instability (p<10-3), lack of a clear strategy for the healthcare system (p=0.005) and the impression by the model of other doctors who left Tunisia (p=0.01).

Conclusions

The rate of migration intentions expressed in this study highlights the emergent need of interventions emanating from the Tunisian health-care system’s problems in order to stop the flow of young doctors towards developed countries in quest of better conditions.

Disclosure

No significant relationships.

The support of healthcare workers suffering from COVID 19

Introduction

The COVID-19 pandemic has focused attention on the challenges and risks faced by frontline healthcare workers (HCW).

Objectives

To describe the quality of management of HCW affected by the COVID-19.

Methods

This is a cross-sectional study enrolling all HCW of Farhat Hached Academic hospital who had been affected by COVID-19 during the period from september to December 2020.

Results

During the study period, 267 HCW were affected with a mean age of 42.3 ±10 years and a ratio-sex of 0.25. The most represented category was nurses (33.3%) followed by technicians (26.1%). Gynecology department had the highest number of affected HCW (14.4%).The majority of participants (97.4%) reported a medical care. Twelve HCW (4.5%) were hospitalized with an average length of hospital stay of 7.55 ± 6.12 days. The average length of sick leave was 18.68 ± 10.99 days. During the lockdown, 38.6% of HCW took care of their children without any external help. All of the HCW were supported by phone calls from colleagues in 88.4% of cases, the hierarchy in 67.4% of cases, occupational medicine in 60.3% of cases.

Conclusions

The impact of COVID 19 is greater in HCW than in the general population. The affected staff should have a multidimensional management to avoid post covid sequelae in both physical and mental levels.

Disclosure

No significant relationships.

Psychosocial skills of ICU healthcare staff providing care to patients with COVID-19

Introduction

The COVID-19 crisis has imposed deep improvements in ICU responsiveness face to unprecedented and uncertain situations. In addition to strengthening logistics resources, this responsiveness required the development of psychosocial skills of healthcare providers, especially in ICU.

Objectives

To assess extrinsic factors interfering with psychosocial skills of the staff working in COVID-19 ICU and to analyze the different dimensions of these skills.

Methods

This is an observational descriptive study conducted at the COVID-19 ICU of an Academic Hospital, during a one-month period. All healthcare providers were enrolled. Data collection was based on a self-administered questionnaire including: socio-demographic factors; the general perception of work in covid-19 ICU and psychosocial skills. Six dimensions were explored separately, then by a standardized scale ranging from 0 to 100.Three levels of satisfaction were considered.

Results

Fifty-five healthcare providers were enrolled. The average age was 32 years. The sex ratio was 0.25. Mean scales of satisfaction were 53.6 for professional status and occupational security; 62.4 for working conditions and 69.8 for relational aspects. The most altered extrinsic factors were satisfaction regarding the salary and satisfaction regarding the administration policy with mean scores of 15 and 10 respectively. Satisfying psychosocial skills were creative and critical thoughts, self-awareness and empathy for others, communication and interpersonal relationships. Whereas the most impaired skills were stress management and problems solving, with mean scales of 49.6 and 68.3 respectively.

Conclusions

Psychosocial skills were generally acceptable. However, they could be improved by specific actions targeting extrinsic factors.

Disclosure

No significant relationships.

Assessing sexual health status among Tunisian ICU healthcare providers in times of the COVID-19

Introduction

The COVID-19 pandemic has dramatically affected ones well-being. ICU healthcare providers are particularly concerned by this impact which includes physical, mental and socioeconomic repercussions. Others health dimensions could be deeply affected but not well explored such as the psycho-sexual status.

Objectives

The aim of this study was to assess sexual health status among ICU healthcare providers.

Methods

This was a cross-sectional study enrolling Tunisian ICU healthcare providers and conducted between July and September 2021. Data collection was based on a self-administrated questionnaire. To assess sexuality, Arabic validated versions of the IIEF-15 and the FSFI was used for male and female respectively. The Fear of COVID-19 Scale and the Rosenberg Self-esteem questionnaire were also used.

Results

Twenty ICU workers (13 physicians and 7 nurses) were enrolled. The mean age was 28.2 years and the sex ratio was 2.3. All participants were involved in COVID-19 crisis management and 80 % reported an increase in their workload. The mean Rosenberg scale was 27 suggesting a low self-esteem. The mean Covid19 Fear Scale was 26 ± 2. For the IIEF-15 the mean score was 17 ± 3 (moderate erectyl dysfunction) and the most damaged dimension was the intercourse satisfaction. For the FSFI scale, the mean was 23 ± 5 witch (a low sexual dysfunction). A high sexual desire with a lack in the satisfaction dimension was reported in 90% of cases. Only 4 participants have consulted a sexologist.

Conclusions

COVID-19 has a serious sexual impact in ICU healthcare providers justifying urgent psychological interventions.

Disclosure

No significant relationships.