Coping, social support and medical factors on psychosocial impact in couples experiencing infertility.

This study assessed dyadically the relationship between psychosocial impact of infertility experienced by 87 couples and individual coping strategies, perceived social support and some medical factors. Although problem-focused strategies emerged as positive, certain side effects on partner were revealed. Social support was related to psychosocial outcomes in a positive way, cognitive component of coping strategies resulted as a prominent factor on individual's adjustment as well as the partner's role. Findings suggest the convenience of promoting the awareness about the effects of each partner's feelings, behaviors and beliefs on his/her individual's well-being in this field due to the interdependent context in which they are. Infertility counselors may foster this process by evaluating and educating to them about the functionality of these factors.

Expression of Non-T Cell Activation Linker (NTAL) in Jurkat Cells Negatively Regulates TCR Signaling: Potential Role in Rheumatoid Arthritis.

T lymphocytes are key players in adaptive immune responses through the recognition of peptide antigens through the T Cell Receptor (TCR). After TCR engagement, a signaling cascade is activated, leading to T cell activation, proliferation, and differentiation into effector cells. Delicate control of activation signals coupled to the TCR is needed to avoid uncontrolled immune responses involving T cells. It has been previously shown that mice deficient in the expression of the adaptor NTAL (Non-T cell activation linker), a molecule structurally and evolutionarily related to the transmembrane adaptor LAT (Linker for the Activation of T cells), develop an autoimmune syndrome characterized by the presence of autoantibodies and enlarged spleens. In the present work we intended to deepen investigation into the negative regulatory functions of the NTAL adaptor in T cells and its potential relationship with autoimmune disorders. For this purpose, in this work we used Jurkat cells as a T cell model, and we lentivirally transfected them to express the NTAL adaptor in order to analyze the effect on intracellular signals associated with the TCR. In addition, we analyzed the expression of NTAL in primary CD4+ T cells from healthy donors and Rheumatoid Arthritis (RA) patients. Our results showed that NTAL expression in Jurkat cells decreased calcium fluxes and PLC-γ1 activation upon stimulation through the TCR complex. Moreover, we showed that NTAL was also expressed in activated human CD4+ T cells, and that the increase of its expression was reduced in CD4+ T cells from RA patients. Our results, together with previous reports, suggest a relevant role for the NTAL adaptor as a negative regulator of early intracellular TCR signaling, with a potential implication in RA.

Suicidal Behavior and Problematic Internet Use in College Students.

BACKGROUND: Suicidal behavior, especially in young populations such as university students, is currently one of the most concerning health problems worldwide, suicide being the second leading cause of death among students. Although literature is still scarce, one of the risk factors that correlates the most with suicidal behavior in young people appears to be problematic internet use (PIU). The aim of this study was to investigate the relationship between PIU and suicidal behavior in a Spanish university population. METHOD: An ex post facto prospective design was used with a sample of 1,386 Spanish university students (68.7% women and 31.3% men). PIU was assessed by means of the Internet Addiction Test (IAT) and psychological problems by means of the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM). RESULTS: The results confirm the relationship between PIU and suicidal behavior, principally alongside those of social isolation and depression, this risk being 3.78 times higher among women with PIU and 5.58 times higher in men. CONCLUSIONS: PIU appears as a risk factor for suicidal behavior that must be taken into account together with social isolation, subjective distress and depression.

A longitudinal comparative study of a multicouple group and single-couple psychosocial intervention while experiencing infertility.

This is a quasi-experimental, nonequivalent design study investigating the efficacy of multicouple group and single-couple intervention formats aimed at diminishing the psychosocial impact of infertility. The review studies carried out to date that have assessed this subject do not show consistent findings and although increasing the efficacy and efficiency of intervention formats more than justifies their analysis, there are no studies making this particular comparison. Eighty-seven infertile couples who were in assessment for their infertility and/or were close to undergoing some kind of assisted reproductive technology process participated in a psychosocial intervention either under the multicouple group or single-couple subconditions, or acted as controls. The variables of depression, anxiety, and fertility quality of life were used for evaluating psychosocial impact. Comparisons were made: (a) between the intervention condition and controls and (b) between the two subconditions. The results support the efficacy of the intervention both in the dyadic latent growth curve models analysis carried out and in the treatment effect calculation. Although in the comparison between the multicouple and single-couple format, some differences generally favoring the single format one were found, they were not conclusive. Therefore, the results are in line with review studies that did not find the group format to be more effective. Although this study provides valuable information, its limitations mean that further research needs to be carried out. When selecting the intervention format, therapists should also weigh up others aspects, such as the intervention goal, patient's needs and characteristics, reproductive history, and current stage of infertility.

Study on the Interdependent Relationship between the Marital Satisfaction Variable and the Psychosocial Impact of Infertility and Anxiety Disposition, According to Gender.

This study assessed the relationship between the marital satisfaction variable and the psychosocial impact of infertility and anxiety disposition, testing for possible gender-based differences. Comparisons performed on 87 couples did reveal differences and analyses disclosed that depression, anxiety and quality of life can influence the assessment each partner makes of their relationship, through an interdependent process. One partner's marital satisfaction can be influenced by those variables in the other partner. These findings indicate that psychosocial care for infertile couples must involve both partners and that they should be made aware of the effect of interdependence on marital satisfaction.

Subjective well-being and vulnerability related to problematic Internet use among university students with and without disabilities: A comparative study.

This study aims to observe whether people with disabilities experience problematic Internet use (PIU) like that of young people without disabilities; to relate PIU to psychological distress in young disabled people and to determine whether these problems are similar to or different from those experienced by young people without disabilities. The sample comprised 408 university students with disabilities and 1386 university students without disabilities from several Spanish universities. PIU was evaluated using the Internet Addiction Test (IAT) and psychological distress was evaluated using the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM). The group of university students with disabilities showed less PIU than the nondisabled students, but the worst scores in variables referencing psychological discomfort were found among those students with disabilities who also had PIU. Although the results are not completely generalizable, PIU is related to bigger problems in disabled people for whom it represents a higher risk than for people without disabilities.

Personality Prototypes in People with Type 1 Diabetes and Their Relationship with Adherence.

Type 1 diabetes (Dm1) is a chronic endocrine and metabolic disease that affects the whole person and requires active, decisive treatment. However, personality traits may influence a patient's adherence to treatment guidelines. The objective of this work is firstly to identify the 3 Asendorpf personality prototypes (resilient, undercontrolled and overcontrolled) in a sample of Dm1 individuals and determine whether there are any differences in comparison with a control sample; and, secondly, to study their association with adherence to self-care guidelines using both physiological indicators (HbA1C) and self-report measures. To achieve these objectives, a descriptive cross-sectional study was carried out. The sample comprised 294 participants, of whom 104 were people with Dm1 and 190 were controls. The participants, aged between 14 and 34 years, were classified by their scores in NEO-FFI-R, according to the personality characteristics inherent to Asendorpf's prototypes. Asendorpf's 3 prototypical personality patterns were found both in the group of people with Dm1 and in the control sample. These patterns showed different degrees of association with adherence to self-care guidelines for this disease and with psychological health factors. Importance should therefore be attached to the personality traits and Asendorpf prototypes of people with Dm1 when proposing interventions to address medical, psychological, and behavioral aspects.

Study of the Differential Consequences of Neglect and Poverty on Adaptive and Maladaptive Behavior in Children.

The consequences of physical neglect on retardation in the development of adaptive behaviors and the increased risk of poor physical and mental health are well documented. As physical neglect is a phenomenon found almost exclusively among socially deprived people, it is important to distinguish the health effects caused by neglect from those caused by poverty. The objective of this study was to compare the effects of poverty and physical neglect on the development of problematic externalizing and internalizing behaviors, adaptive skills, and school problems among school children between the ages of 3 and 12. A group of 157 children were chosen from 28 Andalusian schools and classified in three homogeneous groups. Children in group 1 (n = 53) had two target conditions: living in slums (poverty) and suffering from neglect. Children in group 2 (n = 52) had one target condition: living in the same slums as the children in group 1, but not suffering from neglect. Group 3 (n = 52) consisted of children from other (non-slum) neighborhoods who did not suffer from neglect. Adaptive and maladaptive behaviors were evaluated with the Behavior Assessment System for Children (BASC). Significant differences were found between group 1 and group 2, but there were no important differences between group 2 and group 3. The conclusion was that externalizing and internalizing problems, school problems, and low adaptive skills found in neglected children were associated with neglect rather than with poverty or socially deprived environments.

The diagnostic value of pleural fluid homocysteine in malignant pleural effusion.

BACKGROUND: Pleural fluid homocysteine (HCY) can be useful for diagnosis of malignant pleural effusion (MPE). There are no published studies comparing the diagnostic accuracy of HCY with other tumour markers in pleural fluid for diagnosis of MPE. The aim was to compare the accuracy of HCY with that of carcinoembryonic antigen (CEA), cancer antigen (CA) 15.3, CA19.9 and CA125 in pleural fluid and to develop a probabilistic model using these biomarkers to differentiate benign (BPE) from MPE. METHODS: Patients with pleural effusion were randomly included. HCY, CEA, CA15.3, CEA19.9 and CA125 were quantified in pleural fluid. Patients were classified into two groups: MPE or BPE. By applying logistic regression analysis, a multivariate probabilistic model was developed using pleural fluid biomarkers. The diagnostic accuracy was determined by receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC). RESULTS: Population of study comprised 133 patients (72 males and 61 females) aged between 1 and 96 years (median = 70 years), 81 BPE and 52 MPE. The logistic regression analysis included HCY (p<0.0001) and CEA (p = 0.0022) in the probabilistic model and excluded the other tumour markers. The probabilistic model was: HCY+CEA = Probability(%) = 100×(1+e-z)-1, where Z = 0.5471×[HCY]+0.3846×[CEA]-8.2671. The AUCs were 0.606, 0.703, 0.778, 0.800, 0.846 and 0.948 for CA125, CA19.9, CEA, CA15.3, HCY and HCY+CEA, respectively. CONCLUSIONS: Pleural fluid HCY has higher accuracy for diagnosis of MPE than CEA, CA15.3, CA19.9 and CA125. The combination of HCY and CEA concentrations in pleural fluid significantly improves the diagnostic accuracy of the test.

A New Intervention Procedure for Improving Classroom Behavior of Neglected Children: Say Do Say Correspondence Training.

Although neglect is the most common form of child maltreatment, a review of the literature since 1980 reveals a lack of controlled child neglect intervention programs. The aim of this study is to assess a new intervention program to improve the classroom behavior of children exposed to neglect only, by reducing disruptive conduct and promoting adaptive conduct. Two matched groups were selected with children of the same ages, sex, and social class (cultural and economic level) and with mothers of similar ages. The experimental group comprised of five children suffering from neglect and no other type of maltreatment. The control group had five children not abused or neglected. All the children were in the same class at school. The percentage of time per session that each child spent engaged in disruptive behavior was measured (baseline) and was found significantly higher among neglected children. Say-Do-Say Correspondence Training was applied with the neglected children and a rapid, significant reduction in their disruptive behavior was observed (and statistically confirmed), bringing such behavior down to the level of the control (i.e., non-neglected) children. These results were maintained when the intervention was halted. We concluded that the adaptive and classroom behavior of neglected children can be improved with this non-intrusive intervention.

Perceptual Styles and Cannabis Consumption Prediction in Young People.

Given that risk perception has been found to be both a vulnerability and a protective factor with respect to consumption, the objectives of this study were to find out whether there exist specific patterns of risk perception associated with cannabis use and, if so, how they relate to cannabis consumption and to the sources of information on drugs accessed by young people. An ex post facto study was carried out with 1851 young Andalusians aged 18 to 29, using an adaptation of the Andalusian Government "Andalusian Population versus Drugs" survey. For the first objective, a cluster analysis was carried out in which three perceptual style groups were formed: "Strict", "Permissive-Awareness" and "Lax". Cannabis use in the "lax" group was found to be 14.31 times more frequent than in the "strict" group and 2.75 times more frequent than in the "permissive-awareness" group. A logistic regression analysis was also performed, which correctly predicted 80.4% of users and non-consumers. Correlation was found between perceptual styles and the sources of information used about drugs. This study identified three different risk perception styles that heavily correlated to cannabis consumption and to the type of sources young Andalusians use to obtain information about drugs, suggesting the need for a change in preventive policy.

Can parenting practices predict externalizing behavior problems among children with hearing impairment?

Objective: To identify possible differences in the level of externalizing behavior problems among children with and without hearing impairment and determine whether any relationship exists between this type of problem and parenting practices. Methods: The Behavior Assessment System for Children was used to evaluate externalizing variables in a sample of 118 boys and girls divided into two matched groups: 59 with hearing disorders and 59 normal-hearing controls. Results: Significant between-group differences were found in hyperactivity, behavioral problems, and externalizing problems, but not in aggression. Significant differences were also found in various aspects of parenting styles. A model for predicting externalizing behavior problems was constructed, achieving a predicted explained variance of 50%. Conclusion: Significant differences do exist between adaptation levels in children with and without hearing impairment. Parenting style also plays an important role.

Can parenting practices predict externalizing behavior problems among children with hearing impairment?

OBJECTIVE: To identify possible differences in the level of externalizing behavior problems among children with and without hearing impairment and determine whether any relationship exists between this type of problem and parenting practices. METHODS: The Behavior Assessment System for Children was used to evaluate externalizing variables in a sample of 118 boys and girls divided into two matched groups: 59 with hearing disorders and 59 normal-hearing controls. RESULTS: Significant between-group differences were found in hyperactivity, behavioral problems, and externalizing problems, but not in aggression. Significant differences were also found in various aspects of parenting styles. A model for predicting externalizing behavior problems was constructed, achieving a predicted explained variance of 50%. CONCLUSION: Significant differences do exist between adaptation levels in children with and without hearing impairment. Parenting style also plays an important role.

Evaluation of Pleural Fluid Lactate for Diagnosis and Management of Parapneumonic Pleural Effusion.

BACKGROUND: The aim was to measure the accuracy of pleural fluid lactate concentration for diagnosis of parapneumonic pleural effusion (PPE) and to discriminate between uncomplicated (UPPE) and complicated PPE (CPPE). METHODS: Pleural fluid lactate was measured in patients with pleural effusion. Patients were classified into two groups according to the etiology of pleural effusion: PPE and NOT PPE. RESULTS: We studied 173 patients. Thirty patients were PPE (10 UPPE and 20 CPPE) and 143 were NOT PPE. The AUC value was 0.831 (p < 0.0001) and the optimal cutoff value was 5.6 mmol/L exhibiting 70% sensitivity and 90.9% specificity for diagnosis of PPE. Also, pleural fluid lactate could be used to discriminate between UPPE and CPPE, the AUC value was 0.740 (p = 0.0089) and the optimal cutoff value was 10.2 mmol/L, exhibiting 45% sensitivity and 90% specificity. CONCLUSIONS: Pleural fluid lactate has a high accuracy for diagnosis and management of PPE.

Genetic variants within immune-modulating genes influence the risk of developing rheumatoid arthritis and anti-TNF drug response: a two-stage case-control study.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic autoimmune disease that arises as a result of the interaction between genetic and environmental factors. A growing body of research suggests that genetic variants within immune-related genes can influence the risk of developing the disease and affect drug response. MATERIALS AND METHODS: To test this hypothesis, we carried out a comprehensive two-stage case-control study in a White population of 1239 White RA patients and 1229 healthy controls to investigate whether 49 single nucleotide polymorphisms within or near 17 immune-related genes modulate the risk of developing RA and antitumor necrosis factor (anti-TNF) drug response. RESULTS: Logistic regression analyses showed that carriers of the IL4rs2070874T and IL4rs2243250T and IL8RBrs1126580A alleles or the IL8RBrs2230054C/C genotype had a significantly increased risk of developing RA [odds ratio (OR)=1.37, 95% confidence interval (CI) 1.13-1.67, P=0.0016; OR=1.24, 95% CI 1.03-1.49, P=0.020; OR=1.23, 95% CI 1.08-1.41, P=0.002 and OR=1.19, 95% CI 1.04-1.36, P=0.01, respectively]. The association of the IL4 variants was further supported by a meta-analysis including 7150 individuals (P =0.0010), whereas the involvement of the IL8RB locus in determining the susceptibility to RA was also supported by gene-gene interaction analyses that identified significant two-locus and three-locus interaction models including IL8RB variants that act synergistically to increase the risk of the disease (P=0.014 and 0.018). Interestingly, we also found that patients harbouring the IFNGrs2069705C allele showed a significantly better response to anti-TNF drugs than those patients carrying the wild-type allele (P=0.0075). CONCLUSIONS: Our data suggest that IL4 and IL8RB loci may have a small-effect genetic impact on the risk of developing RA, whereas IFNG might be involved in modulating the response to anti-TNF drugs.

Influence of the HER2 Ile655Val polymorphism on trastuzumab-induced cardiotoxicity in HER2-positive breast cancer patients: a meta-analysis.

BACKGROUND: The HER2 655 A>G genetic variant has recently been associated with trastuzumab-induced cardiotoxicity in HER2 breast cancer patients. Considering previous results, the aim of our study was to validate the role of this polymorphism as a predictor of the cardiac toxicity of trastuzumab in breast cancer patients. METHODS: Our study population was composed of 78 HER2 breast cancer patients receiving trastuzumab. The HER2 655 A>G (rs1136201) genetic variant was genotyped using TaqMan allelic discrimination technology. Patients were classified on the basis of the occurrence of cardiotoxic events or the absence of cardiotoxic events during 1 year after the first infusion. RESULTS: The HER2 655 A>G polymorphism was significantly associated with cardiotoxicity: AG versus AA [P=0.012, odds ratio (OR)=5.12, 95% confidence interval (CI) 1.43-18.36], AG+GG versus AA (P=0.01, OR=5.72, 95% CI 1.50-21.76), AG versus AA+GG (P=0.005, OR=7.17, 95% CI 1.82-28.29). A meta-analysis combining these data with the results from previous studies confirmed this association. CONCLUSION: Our results support the role of the HER2 655 A>G polymorphism as a genetic marker of trastuzumab-induced cardiotoxicity in HER2-positive breast cancer patients.

Homocysteine: new tumor marker in pleural fluid.

There are no published studies examining the utility of total homocysteine (HCY) in pleural fluid. The aim was to measure the accuracy of pleural fluid HCY concentration for diagnosis of malignant pleural effusion (MPE). We studied pleural fluids obtained by thoracocentesis in patients with pleural effusion. Pleural fluid HCY concentration was measured by immunonephelometry using N Latex HCY reagent with monoclonal antibody in automated analyzers BNII (Siemens Diagnostics®). Patients were classified into two groups according to the etiology of pleural effusion: benign pleural effusions (BPE) and MPE. Pleural effusion was categorized as MPE if malignant cells were demonstrated in pleural fluid or pleural biopsy. The accuracy of pleural fluid HCY concentration for diagnosis of MPE was determined using receiver operating characteristic (ROC) techniques by analyzing the area under the ROC curve (AUC). We studied 89 patients with ages between 1 and 96 years old (median = 66). Forty-eight patients were BPE and 41 were MPE. Pleural fluid HCY concentration was significantly higher in patients with MPE (median = 13.70 µmol/L) than in those with BPE (median = 8.05 µmol/L). The AUC value was 0.833 (95 % confidence interval (CI) 0.739-0.903). The optimal cutoff value was 13.1 µmol/L exhibiting 56.1 % (95 % CI 39.8-71.5) sensitivity and 85.4 % (95 % CI 72.2-93.9) specificity. Pleural fluid HCY concentration showed high diagnostic accuracy to predict whether a pleural effusion is benign or malignant. Pleural fluid HCY concentration may be measured easily and quickly in automated analyzers and could be a tumor marker commonly used for diagnosis of MPE.

Genetic variants within the TNFRSF1B gene and susceptibility to rheumatoid arthritis and response to anti-TNF drugs: a multicenter study.

BACKGROUND: Recent research suggests that genetic variants in the tumor necrosis factor receptor 2 (TNFRSF1B) gene may have an impact on susceptibility to rheumatoid arthritis (RA) and drug response. The present population-based case-control study was carried out to evaluate whether 5 tagging single-nucleotide polymorphisms (SNPs) within the TNFRSF1B gene are associated with the risk of RA and response to antitumor necrosis factor (TNF) drugs. METHODS: The study population included 1412 RA patients and 1225 healthy controls. A subset of 596 anti-TNF-naive RA patients was selected to assess the association of TNFRSF1B SNPs and drug response according to the EULAR response criteria. RESULTS: We found that carriers of the TNFRSF1Brs3397C allele had a significantly increased risk of developing RA (P=0.0006). Importantly, this association remained significant after correction for multiple testing. We also confirmed the lack of association of the TNFRSF1Brs1061622 SNP with the risk of RA in the single-SNP analysis (P=0.89), but also through well-powered meta-analyses (PDOM=0.67 and PREC=0.37, respectively). In addition, our study showed that carriers of the TNFRSF1Brs3397C/C, TNFRSF1Brs1061622G/G, and TNFRSF1Brs1061631A/A genotypes had an increased risk of having a worse response to anti-TNF drugs at the level of P less than 0.05 (P=0.014, 0.0085 and 0.028, respectively). We also observed that, according to a log-additive model, carriers of the TNFRSF1Brs3397C or TNFRSF1Brs1061622G alleles showed an increased risk of having worse response to anti-TNF medications (P=0.018 and 0.0059). However, the association of the TNFRSF1Brs1061622 SNP only reached marginal significance after correction for multiple testing according to a log-additive model (P=0.0059) and it was not confirmed through a meta-analysis (PDOM=0.12). CONCLUSION: Our results suggest that the TNFRSF1Brs3397 variant may play a role in modulating the risk of RA, but does not provide strong evidence of an impact of TNFRSF1B variants in determining response to anti-TNF drugs.