Psychometric Validation of the Portuguese Obsession with COVID-19 Scale (PT-OCS).

The psychological effects of the COVID-19 pandemic on the Portuguese population are quite relevant and partially related to their repetitive and disruptive thinking about the disease. The successive periods of lockdown contributed to an additional burden on the family-work-life balance for parents. This study aims to validate the Portuguese version of the Obsession with COVID-19 Scale (PT-OCS), which was developed using a general sample from several regions of the country (n = 531) together with a specific sample of Portuguese parents (n = 109). The confirmatory factor analysis results indicate that the PT-OCS includes a set of excellent psychometric properties concerning both the general sample (χ2(1) = 0.446, p = 0.504; CFI = 1.0; GFI = 1.0; RMSEA = 0.0; standardised RMR = 0.003) and the parent group (χ2(2) = 1.816, p = 0.403; CFI = 1.0; GFI = 0.99; RMSEA = 0.0; standardised RMR = 0.016; Bollen-Stine bootstrap p = 0.65). The scale shows very good reliability (0.84 < α/ω < 0.88). As expected, obsession with COVID-19 was highly correlated with COVID-19 anxiety, and women had higher PT-OCS scores. The findings suggest that the PT-OCS is a reliable and valid measure for both persistent and disruptive thinking about COVID-19 in different groups of the Portuguese population, with potential for studying future epidemic events.

Practical lessons learned from real-world implementation of the molecular classification for endometrial carcinoma.

OBJECTIVES: This study aimed to explore the practical organisational aspects and difficulties in the implementation of the molecular classification of endometrial carcinoma (EC), and to demonstrate its potential impact in prognostic risk group classification. METHODS: We conducted a multicentre, retrospective cohort study of 230 patients with EC diagnosed between 2019 and 2022. Sample processing, clinicopathological, treatment and follow-up data were collected. Molecular classification was obtained by p53 and mismatch repair proteins immunohistochemistry, and POLE next-generation sequencing. RESULTS: Implementation was achieved through centralization of molecular analysis. In practice, it was possible to optimise turnaround times of complete integrative reports for hysterectomy specimens to a median time of 18 workdays. If genetic study was started in endometrial biopsies before surgery, 82.0% were available at the time of multidisciplinary tumour board, compared to 8.4% if performed in hysterectomy. ECs were classified as follows: 37.8% no specific molecular profile, 31.7% p53 abnormal, 24.3% mismatch repair deficient, and 6.1% POLE mutant. Integration of these results with traditional clinicopathologic factors led to a change in prognostic risk group in 15 (6.5%) patients, most being initially allocated to high-intermediate (n = 8) and low (n = 5) risk groups. Eight patients changed to a higher risk, and 7 to a lower risk group, whereas 2 remained in the same group. CONCLUSIONS: Centralization of EC molecular classification is a feasible option for countries with limited resources. Optimization of workflows may be achieved by earlier analysis in biopsies and prioritisation of patients whose results imply changes in risk group classification.

Parenting Styles, Coparenting, and Early Child Adjustment in Separated Families with Child Physical Custody Processes Ongoing in Family Court.

Coparenting conflict and triangulation after separation or divorce are associated with poorer child adjustment when parenting gatekeeping and conflict occur. Fewer studies reported psychosocial adjustment of children under three. We explored the effects of authoritarian and permissive parenting styles and negative coparenting on child adjustment in a purpose sample of 207 Portuguese newly separated/divorced parents (50.2% mothers/49.8% fathers) with sole or joint (49.8%/50.2%) physical custody processes ongoing in court. Parents filled out the Parenting Styles Questionnaire-Parents' report, the Coparenting Questionnaire, and the Strengths and Difficulties Questionnaire. Parenting and coparenting moderations path analysis to predict child adjustment were tested for two groups (2/3-year-old child/>3-year-old-child) and showed a good fit, followed by multigroup path analysis with similarities. Findings suggest harsh parenting and interparental conflict and triangulation as predictors for poor early child adjustment. The ongoing custody process could contribute to increased interparental conflict. The families' unique functioning, parenting, and conflict should be considered in young children custody decisions made in a particularly stressful period when the parental responsibilities' process is still ongoing and conflict may increase to serve the best interest of the child and promote healthy development. Future directions and practical implications are discussed.

Co-Amorphous Formulations of Furosemide with Arginine and P-Glycoprotein Inhibitor Drugs.

In this study, the amino acid arginine (ARG) and P-glycoprotein (P-gp) inhibitors verapamil hydrochloride (VER), piperine (PIP) and quercetin (QRT) were used as co-formers for co-amorphous mixtures of a Biopharmaceutics classification system (BCS) class IV drug, furosemide (FUR). FUR mixtures with VER, PIP and QRT were prepared by solvent evaporation, and mixtures with ARG were prepared by spray drying in 1:1 and 1:2 molar ratios. The solid-state properties of the mixtures were characterized with X-ray powder diffraction (XRPD), Fourier-transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC) in stability studies under different storage conditions. Simultaneous dissolution/permeation studies were conducted in side-by-side diffusion cells with a PAMPA (parallel artificial membrane permeability assay) membrane as a permeation barrier. It was observed with XRPD that ARG, VER and PIP formed co-amorphous mixtures with FUR at both molar ratios. DSC and FTIR revealed single glass transition values for the mixtures (except for FUR:VER 1:2), with the formation of intermolecular interactions between the components, especially salt formation between FUR and ARG. The co-amorphous mixtures were found to be stable for at least two months under an elevated temperature/humidity, except FUR:ARG 1:2, which was sensitive to humidity. The dissolution/permeation studies showed that only the co-amorphous FUR:ARG mixtures were able to enhance both the dissolution and permeation of FUR. Thus, it is concluded that formulating co-amorphous salts with ARG may be a promising option for poorly soluble/permeable FUR.

Placental site trophoblastic tumour: five challenges of patient clinical management.

Placental site trophoblastic tumour is a rare form of gestational trophoblastic disease accounting for about 1%-2% of all trophoblastic tumours. Diagnosis and management of placental site trophoblastic tumour can be difficult.We report a case of a 30-year-old woman diagnosed with a placental site trophoblastic tumour and identify the challenges in diagnosis and treatment of this rare situation. The presenting sign was abnormal vaginal bleeding that started 3 months after delivery. Image exams revealed an enlarged uterus with a heterogeneous mass, with vesicular pattern, and the increased vascularisation serum human chorionic gonadotropin level was above normal range. The histological diagnosis was achieved through hysteroscopic biopsy. Staging exams revealed pulmonary micronodules. The patient was successfully treated with hysterectomy and chemotherapy. The latest follow-up (37 months after diagnosis) was uneventful, and the patient exhibited no signs of recurrence or metastasis.

Dyadic coping, marital adjustment and quality of life in couples during pregnancy: an actor-partner approach.

Objective: This study aimed to examine the impact of dyadic coping on the quality of life of couples during pregnancy and to explore the potential mediating role of marital adjustment on this association.Background: According to the systemic transactional model, pregnancy can be characterised as a situation of dyadic stress because it affects both members of the couple. However, the impact of dyadic coping on couples' quality of life during pregnancy is unexplored. Also, the potential mediating role of marital adjustment on this association remains understudied.Methods: Participants were 320 pregnant women and their partners (N = 640) who completed the Dyadic Coping Inventory, the Dyadic Adjustment Scale and the World Health Organisation Quality of Life instrument. Data were analysed using the actor-partner interdependence mediation model.Results: Results showed that there was an intrapersonal indirect effect of dyadic coping on quality of life through marital adjustment. Moreover, an interpersonal indirect effect was found with fathers' dyadic coping being associated with mothers' quality of life through mothers' marital adjustment.Conclusions: These findings highlight the importance of assessing dyadic coping strategies of couples during pregnancy and targeting them in the psychological support offered to couples as a way of improving their marital adjustment, and consequently, their quality of life.

Anxiety and depressive symptoms during pregnancy, perceived control and posttraumatic stress symptoms after childbirth: A longitudinal mediation analysis.

This longitudinal study evaluated the mediating role of sense of control during labour in the association between anxiety and depression levels during pregnancy and postpartum posttraumatic stress disorder symptoms. Participants were 57 women. Anxiety and depression were assessed during pregnancy; sense of control and childbirth-related posttraumatic stress disorder symptoms were collected 6-8 weeks after childbirth. Higher levels of anxiety and depression were associated with more postpartum posttraumatic stress disorder symptoms through lack of perceived control. For depression, this happened only for primiparous. Interventions targeting mechanisms enhancing perceptions/feelings of control should be offered to these women to prevent/minimize childbirth-related posttraumatic stress disorder.

Anxiety, depression, dyadic adjustment, and attachment to the fetus in pregnancy: Actor-partner interdependence mediation analysis.

Perinatal research has focused essentially on maternal outcomes leaving paternal outcomes unexplored. This cross-sectional study aimed to explore the intrapersonal and interpersonal effects of mothers' and fathers' anxiety and depressive symptoms on their own and their partners' antenatal attachment to the fetus. Additionally, it aimed to explore the mediating role of dyadic adjustment on these associations. Participants, 320 pregnant women and their partners, completed the Hospital Anxiety and Depression Scale, the Dyadic Adjustment Scale, and the Maternal and Paternal Antenatal Attachment Scale. Data were analyzed using the actor-partner interdependence mediation model. Mothers' (ß = -.16, p < .01) and fathers' depressive symptoms (ß = -.38, p < .001) were associated with their levels of antenatal attachment to the fetus. These relationships, however, were mediated by levels of dyadic adjustment (ß = -.08, p < .05; ß = -.09, p < .05, respectively). Fathers' anxiety symptoms were associated with their levels of antenatal attachment to the fetus (ß = .16, p < .05). This relationship was partially mediated by their levels of dyadic adjustment (ß = -.05, p < .05). Finally, fathers' depressive symptoms were associated with mothers' levels of antenatal attachment to the fetus through the mothers' dyadic adjustment levels (ß = -.06, p < .05). Results indicated that anxiety and depressive symptoms as well as lower levels of dyadic adjustment during pregnancy seem to negatively impact the levels of antenatal attachment to the fetus, especially for fathers. Results highlight the need to adopt a dyadic perspective to understand mothers' and fathers' outcomes during pregnancy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Benign Metastasizing Leiomyoma of the Uterus: Rare Manifestation of a Frequent Pathology.

Benign Metastasizing Leiomyoma (BML) is a rare condition with few cases reported in the literature. It is usually incidentally diagnosed several years after a primary gynecological surgery for uterine leiomyoma. Differential diagnosis of BML is complex requiring an extensive work-up and exclusion of malignancy. Here, we report two cases of BML based on similarity of histopathological, immunohistochemical, and genetic patterns between lung nodules and uterine leiomyoma previously resected, evidencing the variability of clinical and radiological features of BML. We highlight the importance of 19q and 22q deletions as highly suggestive of BML. These findings are particularly relevant when there is no uterine sample for review.

The role of pathology in the management of patients with endometrial carcinoma.

Pathology plays a critical role in every step in the management of endometrial carcinoma patients. In this review, we describe the state of the art of pathological examination, including examination of endometrium biopsy; intra-operative evaluation with gross examination and frozen section; and grossing of hysterectomy specimen and its histological and immunohistochemistry study. The main pathologic findings in each step are described, as well as limitations and difficulties that may ensue. We highlight the important pathologic parameters that determine treatment options and prognosis of endometrial cancer patients.

Análise das dificuldades relacionadas ao seguimento de condutas terapêuticas do adolescente com diabetes mellitus tipo 1 / Problems with adherence to treatment among adolescents with diabetes mellitus type 1

INTRODUCTION: Diabetes Mellitus type 1 (DM1) is a chronic degenerative disease with high impact on the lives of children and adolescents. The DM1 affects mainly children and young adults under 30 years old, with a predominance from 10 to 14 years old. As a chronic disease, involves changes in daily habits, being following the recommendations of health professionals one of the main conducts to achieve such changes, however, this follow-up is not easy and can directly influence the glycemic control and lead to complications OBJECTIVE: Identify the difficulties of adolescent with DM1 to treatment adherence. The recommendations of this treatment are related to the blood glucose measurements, using a diet plan and insulin application METHODS: The study included 15 adolescent with DM1, of both genders, aged 10-19 years participating in a multidisciplinary group at an outpatient unit in São Paulo, Brazil, aged 13,93 ± 2.4 years, diagnosed with DM1 with an average time of 4.5 years. The following evaluations were employed:1) individual interviews for identification and clinical characterization; 2) characterization of cardiovascular and metabolic parameters; 2) anthropometric assessment and 4) application of a questionnaire with questions about problems of blood glucose measurements, diet plan and insulin application. Data collection was performed before medical appointment with an endocrinologist in a hospital in São Paulo state RESULTS: The identified difficulties and cardio-metabolic variables showed the adolescents presented uncontrolled blood glucose levels, doing the rotation of insulin incompletely and face many daily difficulties to perform the appropriate treatment, being the most frequently reported the insulin application and proper nutrition CONCLUSION: Adolescents with type 1 diabetes presented difficulties in adherence to treatment, mainly o follow insulin treatment and proposals for changes in eating habits by following a diet. ...

INTRODUÇÃO: O diabetes mellitus Tipo 1 (DM1) é uma doença crônico-degenerativa de grande impacto na vida de crianças e adolescentes. O DM1 acomete, principalmente, crianças e adultos jovens com idade inferior a 30 anos, com predomínio dos 10 aos 14 anos. Como uma doença crônica, envolve mudança nos hábitos cotidianos, sendo o seguimento das recomendações dos profissionais de saúde um dos principais comportamentos para se alcançar tais mudanças, entretanto, este seguimento não é fácil e pode repercutir diretamente no controle glicêmico e ocasionar complicações OBJETIVO: Esta pesquisa teve por objetivo identificar as dificuldades que adolescentes com diagnóstico de DM1 relatam para seguirem as recomendações terapêuticas prescritas para o tratamento do diabetes. Tais recomendações dizem respeito, mais especificamente, à mensuração da glicemia, utilização do plano alimentar e aplicação de insulina MÉTODO: Participaram do estudo 15 adolescentes com DM1, de ambos os sexos, na faixa etária de 10 a 19 anos, que participam de um grupo multidisciplinar em um ambulatório de um município, no interior do Estado de São Paulo, com idades de 13,93 ± 2,4 anos, diagnosticados com DM1, em média há 4,5 anos. Foram utilizadas as seguintes avaliações: 1) entrevistas individuais para identificação e caracterização clínica; 2) caracterização dos parâmetros cardiovasculares e metabólicos; 2) avaliação antropométrica e 4) aplicação de questionário sobre dificuldades que incluíram questões sobre mensuração da glicemia, de seguimento do plano alimentar e de aplicação de insulina. A coleta de dados foi realizada antes da consulta médica da endocrinologista, em um hospital do interior do Estado de São Paulo RESULTADOS: Pelas dificuldades identificadas e variáveis cardiometabólicas os adolescentes avaliados estão com descontrole glicêmico, realizam o rodízio de insulina de forma incompleta e enfrentam diversas dificuldades diárias para realizar o tratamento adequado, ...

AIDS: estudo da epidemia na cidade de Säo Carlos / AIDS: study of the epidemiologic surveillance - Säo Carlos

Este estudo surgiu frente à necessidade de consolidaçäo das informaçöes dos casos ambulatoriais de HIV+ e AIDS registrados no Ambulatório Regional de Especialidades da cidade de Säo Carlos-SP. Tem como objetivo identificar a populaçäo segundo sexo, faixa etária, estado civil, escolaridade, ocupaçäo, e ainda as variáveis relacionadas ao agravo em estudo - categoria de exposiçäo, exames laboratoriais e classificaçäo - assim como fornecer subsídios ao serviço de saúde. Foram analisados 204 pacientes, sendo 147 do sexo masculino e 57 casos do sexo feminino; a maior parte encontrava-se na faixa etária de 20-39 anos e era composta de solteiros. Na categoria de exposiçäo houve um predomínio da transmissäo heterossexual no sexo feminino e da transmissäo sanguínea (usuário de droga endovenosa) no sexo masculino. Com esta análise será possível acompanhar o desenvolvimento da epidemia na regiäo e desta forma propor medidas preventivas, já que esta constitui a única forma de controle que se dispöe no momento.