Genetic Modulation of HPV Infection and Cervical Lesions: Role of Oxidative Stress-Related Genes.

Human papillomavirus (HPV) infection is a necessary but not sufficient factor for the development of invasive cervical cancer (ICC) and high-grade intraepithelial lesion (HSIL). Oxidative stress is known to play a crucial role in HPV infection and carcinogenesis. In this study, we comprehensively investigate the modulation of HPV infection, HSIL and ICC, and ICC through an exploration of oxidative stress-related genes: CßS, MTHFR, NOS3, ACE1, CYBA, HAP, ACP1, GSTT1, GSTM1, and CYP1A1. Notably, the ACE1 gene emerges as a prominent factor with the presence of the I allele offering protection against HPV infection. The association of NOS3 with HPV infection is perceived with the 4a allele showing a protective effect. The presence of the GSTT1 null mutant correlates with increased susceptibility to HPV infection, HSIL and ICC, and ICC. This study also uncovers intriguing epistatic interactions among some of the genes that further accentuate their roles in disease modulation. Indeed, the epistatic interactions between the BB genotype (ACP1) and DD genotype (ECA1) were shown to increase the risk of HPV infection, and the interaction between BB (ACP1) and 0.0 (GSTT1) was associated with HPV infection and cervical lesions. These findings underscore the pivotal role of four oxidative stress-related genes in HPV-associated cervical lesions and cancer development, enriching our clinical understanding of the genetic influences on disease manifestation. The awareness of these genetic variations holds potential clinical implications.

Dermatomyositis and Crohn's disease - Case report.

Immune-mediated diseases tend to overlap in ways that are not completely understood. When a presentation is not entirely explained by a former condition, other hypotheses should arise. Additionally, the activity of 2 overlapping immune-mediated conditions is not always associated. We present an unusual association between Crohn's disease and dermatomyositis in a 28-year-old man. The patient presented with a 2-month history of proximal muscle weakness and a skin rash with heliotrope periorbital edema. Since the patient had already been diagnosed with Crohn's disease, he was under immunosuppressive therapy, and he had a family history of psoriasis, the diagnosis was not immediate and required an integrative approach. Laboratory analysis revealed elevated creatine kinase, aldolase, lactic dehydrogenase and transaminase levels. He had no symptoms of Crohn's disease exacerbation. Magnetic resonance imaging, electromyography, and muscle biopsy findings were consistent with inflammatory myopathy, although non-specific. Corticosteroids were initiated with clinical and laboratory improvement within 1 month.

Malignant Hypercalcemia Induced by the Ectopic Production of Intact Parathyroid Hormone (PTH).

Malignant hypercalcemia is a common finding in patients with advanced cancer, involving mechanisms like tumor secretion of parathyroid hormone (PTH)-related protein, osteolytic metastases, and tumor production of calcitriol. Although rare, hypercalcemia induced by ectopic tumoral secretion of PTH can be an additional mechanism. Here we present an 84-year-old male patient who was admitted to the hospital with a non-productive cough, anorexia, and a single episode of small-volume hemoptysis. He was diagnosed with stage T4N3M1c left lung small cell carcinoma, and laboratory tests were remarkable for elevated ionized calcium as well as elevated serum intact PTH. A parathyroid 99mTc sestamibi scan showed no changes, suggesting ectopic production of PTH. Being a rare event, malignant hypercalcemia from intact PTH ectopic production should be considered in these patients.

Gastric Metastasis From Lung Adenocarcinoma: An Uncommon Presentation.

Gastric metastasis is an infrequent occurrence, especially when derived from lung adenocarcinomas. They can grossly resemble advanced gastric cancer and require comprehensive evaluations of the patients and their symptoms. Here, we present the case of a 71-year-old patient admitted to our hospital due to intense, cramping abdominal pain. He had been previously diagnosed with a right lower lobe adenocarcinoma of the lung, which was treated in the previous year with chemotherapy and radiotherapy with good clinical response. The abdominal CT scan and the esophagogastroduodenoscopy showed a gastric infiltrating lesion resembling advanced gastric cancer. However, the biopsy showed malignant epithelial neoplasia with features of adenocarcinoma of pulmonary origin. Even though they are an uncommon finding, gastrointestinal metastases may be life-threatening and should be diagnosed as soon as possible, as the advent of molecular studies and new therapies may result in better survival rates.

Family Satisfaction With Critical Care: Before and After the COVID-19 Outbreak.

Introduction Family satisfaction with intensive care units (ICU) is recognized as a key component of the quality of care. As a result, family members are now more involved in the care process, and their needs are recognized throughout the ICU stay. The coronavirus disease 2019 (COVID-19) changed healthcare worldwide, due to the several restrictions imposed; the communication patterns changed drastically, and institutions were forced to adapt to create a balance between security and the needs of relatives. The aim of this study was to assess family members' satisfaction with the ICU and determine if the COVID-19 restructuring affected family satisfaction. Methods A prospective observational study was performed among the designated family members (DFM) of ICU patients over two time periods, a pre-pandemic period from December 2019 to February 2020 and a pandemic period from May 2020 to February 2021. The Family Satisfaction in the Intensive Care Unit 24 (FS-ICU 24) questionnaire, which was given to the DFM, was the instrument used to determine family satisfaction. Results The study involved 290 DFM, 175 during the pre-pandemic phase and 115 during the pandemic period. The overall and domain-specific family satisfaction scores were high (score > 80) in both the pre-pandemic and pandemic periods. The greatest satisfaction levels were related with symptom management and how nurses and doctors cared for the patient. No statistical differences were found between the two time periods. Lastly, a positive association between the two domains explored by FS-ICU 24, satisfaction with care and satisfaction with decision-making process, was verified in both time frames. Conclusion The data obtained revealed very good outcomes on the different FS-ICU 24 domains, in line with other studies in literature. No significant differences were found between the pre-pandemic and pandemic periods, suggesting that the measures implemented during the COVID-19 were successful. The importance of involving families in the decision-making process, providing them with accurate information, and active listening, as well as using better communication skills, is emphasized throughout all these results. The relevance of measuring family satisfaction should be brought to the attention of family members and healthcare professionals so that additional research may be conducted.

Telework and Mental Health during COVID-19.

COVID-19 has come to change societal organization. Due to lockdowns, work typologies have been rethought and telework has gained strength. However, the impact of the constant use of information and communication technologies on the mental health of workers needs to be considered. We aimed to investigate the impact of different work conditions on mental health, to which end we disseminated an online questionnaire during lockdowns to assess imagined surveillance, mobile maintenance expectation, communication overload, feelings of entrapment, depression, anxiety, stress, and flourishing in four groups (employed in telework, employed on-site, employed in layoff, and unemployed). We computed mean comparisons and serial mediations. We show that depression and anxiety were more prevalent in women; parents flourished more than people without children; and people with a higher level of education feel more entrapment. Crucially, we show that telework was associated with imagined surveillance and communication overload, which mediated the association with mobile maintenance expectations and entrapment (which was exacerbated by parenthood), impacting mental health and the quality of life. However, this was also partially observed in the remaining work conditions. Finally, flourishing worked as a protector against mental health issues in all work conditions. We discuss this given the massification of digital migration.

Características psicométricas da Escala de Stress Infantil (ESI) para avaliação do stress em crianças cegas / Psychometric characteristics of the Infantile Stress Scale (ISS) to stress assessment of blind children

Métodos e instrumentos de avaliação psicológica em crianças cegas são escassos. Com o objetivo de validar um método confiável na mensuração do stress nessa população, verificamosas características psicométricas da Escala de Stress Infantil (ESI). Aplicamos o instrumento em 46 crianças cegas congênitas, alunas do Ensino Fundamental do Instituto Benjamin Constant do Rio de Janeiro. A análise fatorial exploratória revelou quatro fatores, conforme esperado, mostrando boa consistência interna das quatro diferentes dimensões da escala. Ao executarmos a análise fatorial confirmatória, detectamos o modelo com um fator como o melhor, como já apontado pela literatura, o que demonstra que as quatro dimensões convergem para um constructo único: stress. A confiabilidade da escala mostrou-se satisfatória, apresentando alfa de Cronbach de 0,91. Este estudo dá subsídios para a validade da ESI na mensuração do stress em crianças cegas.(AU)

Methods and instruments for psychological assessment in blind children are rare. We verified the psychometric characteristics of the Infantile Stress Scale (ISS) with the goal to validate a trustful method of stress measurement in this population. We applied the instrument in 46 congenital blind children of elementary school students from Benjamin Constant Institute of Rio de Janeiro. The exploratory factorial analysis showed four factors as expected, showing good internal consistency of the four scale dimensions. When we executed the confirmatory factor analysis, we detected the one factor model as the best, such as pointed by the literature, what demonstrates that the four dimensions converge to a single construct: stress. The scale reliability was satisfactory with a Conbrach’s alpha of 0.91. This study gives us subsidence to validate the ISS for congenital blind children stress measurement.(AU)

Características psicométricas da Escala de Stress Infantil (ESI) para avaliação do stress em crianças cegas / Psychometric characteristics of the Infantile Stress Scale (ISS) to stress assessment of blind children

Métodos e instrumentos de avaliação psicológica em crianças cegas são escassos. Com o objetivo de validar um método confiável na mensuração do stress nessa população, verificamosas características psicométricas da Escala de Stress Infantil (ESI). Aplicamos o instrumento em 46 crianças cegas congênitas, alunas do Ensino Fundamental do Instituto Benjamin Constant do Rio de Janeiro. A análise fatorial exploratória revelou quatro fatores, conforme esperado, mostrando boa consistência interna das quatro diferentes dimensões da escala. Ao executarmos a análise fatorial confirmatória, detectamos o modelo com um fator como o melhor, como já apontado pela literatura, o que demonstra que as quatro dimensões convergem para um constructo único: stress. A confiabilidade da escala mostrou-se satisfatória, apresentando alfa de Cronbach de 0,91. Este estudo dá subsídios para a validade da ESI na mensuração do stress em crianças cegas.

Methods and instruments for psychological assessment in blind children are rare. We verified the psychometric characteristics of the Infantile Stress Scale (ISS) with the goal to validate a trustful method of stress measurement in this population. We applied the instrument in 46 congenital blind children of elementary school students from Benjamin Constant Institute of Rio de Janeiro. The exploratory factorial analysis showed four factors as expected, showing good internal consistency of the four scale dimensions. When we executed the confirmatory factor analysis, we detected the one factor model as the best, such as pointed by the literature, what demonstrates that the four dimensions converge to a single construct: stress. The scale reliability was satisfactory with a Conbrach’s alpha of 0.91. This study gives us subsidence to validate the ISS for congenital blind children stress measurement.

Estrutura fatorial e propriedades psicométricas da escala de stress infantil adaptada para uma amostra de crianças cegas

Métodos e instrumentos específicos para a avaliação psicológica em crianças cegas são escassos. Contudo, é possível aadaptação de medidas psicológicas de indivíduos videntes para o contexto da cegueira. Com o objetivo de estudar ummétodo confiável na mensuração do estresse nessa população, analisamos as propriedades psicométricas e a estruturafatorial da Escala de Stress Infantil (ESI). O instrumento foi aplicado em 92 crianças cegas congênitas alunas do ensinofundamental do Instituto Benjamin Constant do Rio de Janeiro. A análise fatorial exploratória revelou quatro fatores,conforme esperado, mostrando boa consistência interna das quatro diferentes dimensões da escala. A análise fatorialconfirmatória detectou o modelo com um fator como o melhor, como já apontado pela literatura, o que demonstra queas quatro dimensões convergem para um constructo único: estresse. A confiabilidade da escala mostrou-se satisfatóriaapresentando alfa de Cronbach de 0,91. Esse estudo dá subsídios para a confiabilidade e para a estrutura unifatorialda ESI para medir o estresse em crianças cegas.(AU)

Methods and instruments specifically designed for psychological assessment of blind children are rare. Nevertheless,the adaptation of psychological measures for screening individuals in the blindness context is possible. We analysedthe psychometric properties and the factorial structure of the Infantile Stress Scale (ISS) in order to study a trustfulmethod of stress measurement in this population. The instrument was applied in 92 congenital blind children ofelementary school students from Benjamin Constant Institute of Rio de Janeiro. The exploratory factorial analysisshowed four factors as expected, showing good internal consistency of the four scale dimensions. Confirmatory factoranalysis detected the one factor model as the best, such as pointed by the literature, what demonstrates that the fourdimensions converge to a single construct: Stress. The scale reliability was satisfactory with a Conbrach’s alpha of0.91. This study gives us subsidence of reliability and one-factor structure of the ISS for congenital blind childrenstress measurement.(AU)

Métodos e instrumentos específicos para la evaluación psicológica de los niños ciegos son escasos. Sin embargo, es posible la adaptación de las medidas psicológicas de los videntes en el contexto de la ceguera. A fin de estudiar un método confiable para la medición de estrés en esta población, encontramos las propiedades psicométricas e estructura factorial de la Escala de Estrés Infantil (ESI). El instrumento se aplicó a 92 niños ciegos congénitos de los estudiantes de primaria del Instituto Benjamin Constant de Río de Janeiro. El análisis factorial exploratorio reveló cuatro factores, como era de esperar, que muestra una buena consistencia interna de las cuatro dimensiones diferentes de la escala. Al realizar el análisis factorial confirmatorio, se detectó el modelo con un factor como el mejor, como lo señala la literatura, lo que demuestra que las cuatro dimensiones convergen en un único constructo: el estrés. Fiabilidad de la escala fue satisfactoria que muestra el alfa de Cronbach de 0,91. Este estudio da soporte a la fiabilidad y estructura unifactorial de la ESI para medir de estrés en los niños ciegos.(AU)